CHANGE OF INFORMATION FORM
Registrar’s Office, Drew University
(Complete and bring this form to Holloway 116)
***PLEASE PRINT***
NAME: ________________________ ID#_________________ DATE: __________________
NEW PERMANENT (HOME) ADDRESS:
Street: ___________________________________________________________________________
___________________________________________________________________________
City:
________________________________ state: ____________________ zip:______________
County: ________________________________ Phone: (____) _______________________________
Country: _______________________________
DIPLOMA ADDRESS: (where to send Diploma if different than permanent address):
Street: ___________________________________________________________________________
___________________________________________________________________________
City:
________________________________ state: ____________________ zip:______________
County: ________________________________ Phone: (____) _______________________________
Country: _______________________________
CHANGE OF NAME: (Official Legal documentation Required – See Below)
Previous Name: ______________________________________________________
New Name: __________________________________________________________Effective date: ____________
Signature: ______________________________________________ Date: __________________
**Official Legal Documentation Accepted for Change of Name:
One of the following must be presented to the Registrar’s Office. You must appear in person. We will photocopy your official document:
Marriage License/Marriage Certificate
Divorce Decree
Court Order
(Note: No name changes are permitted after graduation from Drew University)