Change My Data Form

Please Fill Out the Section that Applies to you

Student ID(Required)

Insert

Name(Required)

First Last

Change of Phone Number

Old Number

New Number

Change of Address

New Address

Street Address Apartment # (If Applicable) City State / Province / Region ZIP / Postal Code County

Change of Email

Old Email

New Email

Change of Name

Current Name

First Last

New Name

First Last

Reason for Change

Marriage

Divorce

Other

Marriage, divorce and other require official documentation, such as a marriage license, final divorce decree, etc.

List Documentation Provided

We MUST have a legal copy of documentation.

Old SSN

Insert

New SSN

Insert

File

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 15 MB, Max. files: 4.