REQUEST FOR CHANGE OF LEGAL NAME

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Request for Change of Legal Name

Fill in the blanks of the form below. After it has been completed, click the submit button at the bottom to send the form to Records and Advisement.

Student ID Number:

Contact Phone:

Email:

Purpose:

Current Name

First:

Middle:

Last:

New Name

First:

Middle:

Last:

My spouse is/was a student at Southern Adventist University:

Yes

Your spouse's ID number:

For verification purposes, please enter the last four digits of your Social Security Number in the field below. Your changes CANNOT be processed without this verification.

Note: Remember that a photocopy of the appropriate legal document (marriage license/certificate, court order, etc.) is required and can be hand-delivered, emailed, mailed, or faxed to Records and Advisement. Social Security card or a valid passport may be acceptable in some situations. Send faxes to 423.236.1899. Send emails to recchanges@southern.edu.

Mailing

If you are mailing the legal document please send it to the following address:

Southern Adventist University
Records & Advisement
PO Box 370
Collegedale, TN 37315

REQUEST FOR CHANGE OF LEGAL NAME

Mailing

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