Office of the Registrar 5757 Plaza Drive, Suite 100, Cypress, CA 90630 Office: 800.375.9878 | Fax: 800.536.5919 Email:
[email protected]
NAME CHANGE REQUEST Please submit this request along with supporting documentation to
[email protected]. Acceptable supporting documents include: driver's license; court order; State ID; or marriage certificate. If you are currently enrolled, your name change request will be processed at the end of the session. NAME in Trident’s record now ________________________________________________________ Program _______________________________
Student ID# ______________________________
Date of Birth ____________________________
NEW INFORMATION (Please print) LAST NAME ____________________________________________ FIRST NAME ___________________________________________ MIDDLE NAME OR INITIAL ________________________________
Signature ______________________________________ Date _____________________________
Revised 10.14.2014
