Office of the Registrar / 200 West Kawili St. Hilo, HI 96720-4091 / Student Services Center, First Floor Rm E-101 / Phone: (808) 932-7447 / Fax: (808) 932-7448 / E-mail: uhhro@hawaii.edu
• Complete this form to update the following student personal data:
o Social Security Number Change
o New Permanent Address & Phone Number (Mailing address can be changed via MyUH)
o Address After Graduation (Must have submitted and paid for a Graduation Application)
*Not
e: This for
m is not i
ntended f
or the foll
owing req
uests: change of legal name or declare a preferred first name. Complete the Change of
Name/Preferred Name Request Form to request a name change.
Student Personal Data Update Form
Revised 1/2017
SECTION I: Student Information
Student Name: _________________________________________________ ____ Student ID: ____________________________
Email Address: _________________________________________@hawaii.edu Phone: _________________________________
Student Signature: _____________________________________________________ Date: ____________________________
SEC
TION II: C
hanges/
updates t
o student personal data
I AM REQUESTING TO CHANGE MY SOCIAL SECURITY NUMBER
Former Number: _________________________________ New Number: _________________________________
I AM REQUESTING TO CHANGE MY PERMANENT ADDRESS & PHONE NUMBER (not applicable to WUE students)
Address: ___________________________________________________________________________________________________
City: _____________________ State/Country: ______ __ Zip Code: _________ ___
Phone: ____________ _______
I AM REQUESTING TO CHANGE MY ADDRESS AFTER GRADUATION
I have applied to graduate in (Semester & Year): ___________________________________
Address: ___________________________________________________________________________________________________
City: _____________________ State/Country: ______ __ Zip Code: _________ ___
FOR OFFICE OF THE REGISTRAR USE ONLY:
SPAPERS SPAIDEN
SHADGMQ
EMAIL SENT Date: _______________ Initial: ______________
