Change of Information Form

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Legal Name Change Disclosure

Students may change the name on their academic record for the following reasons: Marriage, Divorce, Legal Name Change, or Correction of an error. Two copies of legal documentation bearing the revised name are required, one of which contains a photograph.

Preferred Name Disclosure

Preferred Name will appear on:

  • Directory Information (Unless a Family Educational Rights and Privacy Act (FERPA) information block has been requested.
  • Class roster
  • Displayed name for College email
  • Profile on Banner Self-Service
  • Reports/List generated for faculty and advisors
  • PCOM Identification Badge

Personal Information

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Phone

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New Address Information

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New Name Information

Reminder

Students may change the name on their academic record for the following reasons: Marriage, Divorce, Legal Name Change, or Correction of an Error. Two copies of legal documentation bearing the revised name are required, one of which contains a photograph.

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Attach Documents

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Preferred Name Information

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