Personal Data Update

PERSONAL DATA UPDATE
Submit this form to update your address, phone, or email, change your name, or to specify a preferred name or pronoun.

Documentation is required for name changes.

Questions: Registrar@uwest.edu
DATE SUBMITTED*

MonthDayYear
Date
NAME*

First NameFamily / Last Name
STUDENT ID*
EMAIL*
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
INTERNATIONAL STUDENT (F-1)*

NOYES
If you are studying in the US on an F-1 Visa, you must submit address and name changes through SEVIS in addition to submitting this form to UWest.

See the International Student Services Advisor for assistance.
CHANGE REQUESTED Select all that apply*

ADDRESSPHONE NUMBEREMAILNAME CHANGEPREFERRED NAMEPREFERRED PRONOUN
NEW ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
NEW PHONE*
Please enter a valid phone number.
TYPE*

MOBILELAND LINE
NEW EMAIL Your my.uwest.edu address will continue to be used as your primary email address while attending.*
example@example.com
REQUIRED DOCUMENTATION

Bring one of the following to the Registrar's Office. The document will be copied for your file and the original returned to you.Once documentation is received, your name will be updated. If you are out of the area, contact Registrar@uwest.edu to make arrangements for submission.

Court order for legal name change/adoption/divorce

   OR   Passport showing new legal name

   OR   Driver's license/ID AND social security card with new legal name

   OR   Marriage license AND social security card with new legal name

If you submit a name change mid-semester, you are responsible for notifying your instructors after submission of this form to the Registrar.

If you would like this name used on your diploma, your name change must be submitted prior to the last day of your final term. If submitting your name change after your diploma is printed, you may place a Diploma Reorder for a one time replacement under the new name. See that form for more details.
NEW LEGAL NAME*

Prefix (optional)First NameMiddle (optional)Family / Last NameSuffix (optional)
Supporting Documentation (Examples: Valid Passport, Driver's License, State Issued ID) - it must have a photo:

Cancelof
Your official school record will be maintained under your legal name. However, we are happy to provide your preferred name and/or preferred pronoun to instructors on the rosters generated by Moodle.

Due to restrictions with our student information system (SIS), we cannot show your preferred name or preferred pronoun on rosters generated from the SIS, which display on the student portal.
PREFERRED NAME*
Enter the name you would like used on class rosters
PREFERRED PRONOUN*
By signing, I verify that I am the student of record and that all information provided on this form is correct.
Signature*

Clear
REGISTRAR'S OFFICE

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Processed:

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Comments:
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PERSONAL DATA UPDATE