Request for Name Change
MSOE Registrar’s Office 1025 N Broadway Milwaukee WI 53202 Phone: 414-277-7215 [email protected] Fax: 414-277-6914
Request for Name Change
Complete the form below and return to the Registrar’s Office with the required documentation indicated below. The signature lines are required for verification purposes.
Documents accepted as proof of name change include: valid driver’s license, government issued photo identification card, birth certificate, valid passport, marriage license, divorce decree (the part that indicates a name change), or court order. Please note: For current international students, your new name must match the name on your passport. Former Legal Name (Last, First Middle): _______________________________________ Former Signature: ____________________________________
ID # or Social Security Number: ____________________________ Birth Date: ___________________________________ I am a:
___ Current Student
___ Former Student or Alumnus
If you are a current student, are you receiving financial aid? Y N Have you worked on campus in any capacity? Y N
New Legal Name (Last, First Middle): ________________________________________ New Signature: __________________________________________ Today’s Date: ______________________________________
If you are a current student and want your name changed on your email, please contact the IT Department at 414-277-7288 or [email protected].
Request for Name Change
Complete the form below and return to the Registrar’s Office with the required documentation indicated below. The signature lines are required for verification purposes.
Documents accepted as proof of name change include: valid driver’s license, government issued photo identification card, birth certificate, valid passport, marriage license, divorce decree (the part that indicates a name change), or court order. Please note: For current international students, your new name must match the name on your passport. Former Legal Name (Last, First Middle): _______________________________________ Former Signature: ____________________________________
ID # or Social Security Number: ____________________________ Birth Date: ___________________________________ I am a:
___ Current Student
___ Former Student or Alumnus
If you are a current student, are you receiving financial aid? Y N Have you worked on campus in any capacity? Y N
New Legal Name (Last, First Middle): ________________________________________ New Signature: __________________________________________ Today’s Date: ______________________________________
If you are a current student and want your name changed on your email, please contact the IT Department at 414-277-7288 or [email protected].
