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Change of Name Form


Must be completed by the student. Employees wishing to change their name need to contact Human Resources.

Student Name: 

Student ID Number:    Social Security Number:

Birth date:     E-mail address:


City:    State:    Zip:

Change Name To: 

Reason for Change:  

By submitting this form, I certify that the above change is true and legal with no fraudulent intent.


If you have any questions please feel free to contact us at:

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