STUDENT INFORMATION CHANGE FORM (LEGAL NAME AND/OR SEX CHANGE)
Thi
s form must be accompanied by legal documentation of the name and/or sex change – see instructions for additional
information and the list of acceptable documentation.
Nam
e that Union College currently has on file (Please print or type)
FI
RST, MIDDLE, LAST (FAMILY NAME) ____________________________________________________
ID
#________________ DATE OF BIRTH____________________UNION EMAIL___________________
STREET____________________________________________________________________________
CI
TY____________________________________________STATE______________ZIP_____________
CO
UNTRY_______________________________________CELL PHONE: ________________________
MARK ALL THAT APPLY:
CH
ANGE OF NAME:
I, the undersigned, hereby request that Union College change its records so that my
ne
w legal name below appears as my name of record.
Ne
w Name of Record (Please print or type)
FI
RST NAME__________________________________________________________
MIDDLE NAME________________________________________________________
LA
ST NAME (FAMILY NAME) _____________________________________________
CHANGE OF SEX:
MALE
FEMALE
STU
DENT SIGNATURE: ________________________________________________DATE: ___________
If y
ou are unable to present the original documents in person, you must submit the Student Information Change
Form and either notarized copies of accompanying documents, or certified copies issued by the governmental agency in
place of notarized copies. See second page of this form for a list of acceptable documents. This form, and all supporting
documents must be returned to the Office of the Registrar, Silliman Hall.
Silliman Hall
Schenectady, NY 12308
Fax 518-388-6173
registrar@union.edu
I, the undersigned, hereby request that Union College change its records so that my
new legal sex below appears as my name of record.
click to sign
signature
click to edit
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