University Of Miami Change Of Name Form
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1CHANGE OF NAME
(Official Record and / or Diploma)
OFFICE OF THE REGISTRAR
CURRENT NAME ON OFFICIAL RECORD
_________________________________________________________________________________
Last Name
First Name
Middle Name
_________ / ______ / ____________
______ / ______ / ______
UM ID or Social Security Number
Date of Birth
____ Please check here if you have graduated or are about to graduate.
Are you an International Student?: ____ NO
____ YES (If yes, you MUST obtain a signature as requested below.)
I WANT TO CHANGE MY NAME TO:
____________________________________ _________________________________ __________________
Last Name
First Name
Middle Name
On my (check one as Official Record will automatically change the Diploma Name):
___ OFFICIAL RECORD – This will also change my name on my Diploma. International students must also
obtain a signature from an International Student and Scholar Services Advisor – see below.
___ DIPLOMA ONLY – Accepted changes for diploma only are adding diacritical marks or changing a
name to an initial. (These diploma name modifications will NOT change your name on your official record.
Your official name on record will appear on all your academic documents including your transcripts. The
name on your transcript MUST be the official name on your record. Thus, if you modify your diploma name,
the name on your transcripts will not match the name on your diploma.)
INTERNATIONAL STUDENTS who are changing the name on the official record, in addition to providing legal
documentation, MUST obtain a signature from an International Student and Scholar Services (ISSS) Advisor
rd
authorizing the name change. ISSS is located in Building 21, Room F, 3
floor.
__________________________________________________________
_______________________
Signature of ISSS Advisor
Date
DOCUMENTATION ATTACHED (Required if changing your official name on record. Documentation must be
original or certified copy. Please mail documentation to the address noted below or bring to our office. Faxed
copies are NOT accepted.) Please check type of document you are providing.
____ Marriage License
____ Divorce Document
____ Naturalization Papers
____ Passport
____ Court Order
____ Birth Certificate*
*Birth certificates are used to correct spelling and cannot be used to change your current name back to
your birth name.
I understand that it is my responsibility to also notify my school/college of my change of name.
SIGNATURE: ________________________________________________ DATE: ________________
EMAIL ADDRESS: ____________________________________________
PHONE NUMBER: ______________________________
FOR OFFICE USE ONLY:
Name change processed by: ___________________________________ Date: _______________
Type of Photo ID Provided:___________________________
121 Whitten University Center
P.O. Box 248026
Coral Gables, FL 33124-6914
FAX: 305-284-6293
Updated 03/11
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