Name Change Request Form North Carolina State University printable pdf download

Name Change Request Form North Carolina State University

NAME CHANGE REQUEST FORM

NORTH CAROLINA STATE UNIVERSITY

Registration & Records

Old Name:

__________________________________________________________________

ID Number:

__________________________________________________________________

Curriculum:

__________________________________________________________________

Class:

Freshman

Sophomore

Junior

Senior

Doctoral

UGS

PBS

(circle those that apply)

***********************PLEASE PRINT***********************

New Name:

__________________________________________________________________

LAST NAME

FIRST NAME

MIDDLE NAME

_____ Single Female

_____ Single Male

_____ Married Female

_____ Married Male

__________________________________________________________________________________

Student Signature

Date

A LEGAL DOCUMENT MUST BE PRESENTED TO INITIATE A NAME CHANGE

_____ Certified Copy of Court Order

_____ Marriage Certificate or Divorce Papers

_____ Other ______________________________________________________________________

________________________________________

Received by

Date

Note: This will not change your Unity ID. If you wish to change your Unity ID, please contact

the Help Desk in the Hillsborough Building, Room 208.

Name Change Request Form North Carolina State University