Ureg University Of Virginia Name/i.d Number Change Form
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1UREG
University of Virginia
Name/I.D Number Change Form
Date
School or
SCPS Center
Previous Last Name:
Previous First and
Middle:
Previous I.D. Number:
New I.D. Number:
(if different)
New Last Name:
(if different)
New First and Middle:
(if different)
Name Changes are only processed for Currently Enrolled Students
or Applicants who are Previous Students
Reason for Change:
A copy of a court order, driver's license, marriage certificate, passport, social security card, or some other official document showing the
new name and /or number must accompany this form.
Mailing Address:
(UREG) Office of the University Registrar
PO Box 400203
Charlottesville, VA 22903-4203
Signature
: ______________________________________________________
Revised - UREG 04-07-09 -
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