Change/Correction of Student Information
Step 1 of 2: Submit
First Name:
*
Last Name:
*
Student ID# or DOB:
*
Change or Correction of Name
New Name:
Former Name:
Preferred Name: *If you'd like to be referred to by a name other than your legal name, please list below.
Please note: Documentation may be needed to complete this request. If so, an Enrollment Services staff member will reach out to you.
Supporting Documentation
Remove
Remove uploaded file
Change or Correction of Social Security Number
New Social Security Number:
Former Social Security Number:
Please upload a copy of your Social Security Card or documentation from the Social Security Office and your photo ID.
Supporting Documentation
Remove
Remove uploaded file
Change or Correction of Birth Date
New Birth Date:
Former Birth Date:
Please upload driver’s license or birth certificate for verification and your Photo ID.
Supporting Documentation
Remove
Remove uploaded file
Change of Program
On-Campus Program
Select One (if applicable)
Accounting & Business Management (AAS)
Accounting (Cert.)
Art (AFA)
Art/Art History (AA)
Art Education (AA)
Astronomy (AS)
Automotive Technology (AAS)
Auto Alignment Specialist (Cert.)
Auto Brake Specialist (Cert.)
Auto Diesel (Cert)
Auto Drivability Specialist (Cert.)
Auto Engines Specialist (Cert.)
Auto Heating/AC Specialist (Cert.)
Auto Parts Specialist (Cert.)
Auto Service Mgt. Tech. (Cert.)
Auto Services Technology (Cert.)
Auto Transmission Specialist (Cert.)
Biological Sciences (AA)
Business (AA)
Business Essentials (Cert.)
CAD/Mechanical Design Technology (AAS)
CAD Drafter (Cert.)
CAD/Mechanical Design Tech. (Cert.)
CAD Technician (Cert.)
Chemistry (AS)
Child Development (AAS)
Child Development Preschool Teacher (Cert.)
Child Development Director (Cert.)
Computer Electronics Technology (AAS)
Computer Electronics Technician (Cert.)
Computer Science (AA)
Community Service Officer Training (Cert.)
Criminal Justice (AA)
Criminal Justice Services (AAS)
Criminal Justice Services (Cert.)
Culinary Arts Professional Kitchen (Cert.)
Dental Hygiene (AAS)
Dental Assisting (Cert.)
Education/Early Childhood (AA)
Education/Elementary Education (AA)
Education/Second Education (AA)
Emergency Medical Technician (Cert.)
Engineering (AS)
English/Literature (AA)
Entrepreneurship (Cert)
Fire Science: First Responder (Cert.)
Fire Science Technology (AAS)
Fire Science Technology (Cert.)
Fire Science: Basic Firefighter Operations (Cert.)
Fire Science: Advanced Technician Firefighter (Cert.)
Fire Science: Firefighter/EMT (Cert.)
First Responder (Cert.)
Fitness and Exercise (AAS)
Fitness: Group Fitness Instructor (Cert.)
Fitness: Personal Trainer (Cert.)
General Math/Science (AS)
Geology (AS)
General Studies (AGS)
Graphic Communications: Multimedia Arts (AAS)
Graphic Communications: Animation (Cert.)
Graphic Communications: Digital Design (Cert.)
Graphic Communications: Web Designer (Cert.)
History (AA)
Income Tax Preparer (Cert)
Industrial Technology: Heating, Ventilation, Air Conditioning (Cert.)
Industrial Electrician (AAS)
Industrial Electrician (Cert.)
Industrial Electrician: Solar Photovoltaic (AAS)
Industrial Electrician: Solar Photovoltaic Technician (Cert.)
Industrial Electrician: Wind Turbine (AAS)
Industrial Electrician: Wind Turbine Technician (Cert.)
Industrial Maintenance Technician (Cert.)
Industrial Mechanic (AAS)
Industrial Mechanic (Cert.)
Industrial Technology: CNC Programmer/Operator (Cert.)
Industrial Technology: Certified Production Technician (Cert.)
Industrial Technology: Industrial Maintenance Technician (Cert)
Industrial Technology: Machinist (Cert.)
Industrial Technology: Manufacturing Technology (AAS)
Industrial Technology: Manufacturing Technology (Cert.)
Industrial Technology: Tool and Die Making (AAS)
Industrial Technology: Welding Technician (Cert.)
Industrial Technology: Welding Specialist (Cert.)
IT: Cybersecurity Defense (AAS)
IT: Cybersecurity Systems (AAS)
IT: Networking (AAS)
IT: Programming (AAS)
IT: Web (AAS)
IT: CISCO Network Associate (Cert)
IT: Computer Support Associate (Cert.)
IT: Computer Technician (Cert.)
IT: Game Design and Development (Cert.)
IT: Google IT Support Professional (Cert.)
IT: Programming (Cert.)
IT: Network Security Specialist (Cert.)
IT: Networking Specialist (Cert.)
IT: Junior Programming (Cert.)
IT: Web Developer Technician (Cert.)
IT: Web Junior Technician (Cert.)
IT: Web Master Technician (Cert.)
Liberal Arts (AA)
Management (AAS)
Mathematics (AA)
Media and Communication Arts: Adv/Public Relations (AA)
Media and Communication Arts: Communication Studies (AA)
Media and Communication Arts: Multimedia (AA)
Media and Communication Arts: Radio/TV/Film (AA)
Music Education (AA)
Music Performance (AA)
Music Production (AAS)
Music Technology (Cert.)
Nursing (AAS)
Nursing: Adv. Bedside Care Provider (Cert.)
Nursing: CNA/Nurse Assistant (Cert.)
Photographic Studies (AAS)
Photography (Cert.)
Physical Education (AA)
Physical Therapist Assistant (AAS)
Physics (AS)
Political Science (AA)
Portrait Photography (Cert.)
pre-Clinical Laboratory Sciences (AA)
pre-Health Professions-Dental Assisting
pre-Health Professions-Dental Hygiene
pre-Health Professions-Nursing
pre-Health Professions-Other
pre-Health Professions-Physical Therapy Assistant
pre-Health Professions-Surgical Technology
pre-Dentistry (AA)
pre-Law (AA)
pre-Medicine (AA)
pre-Nursing (AA)
pre-Occupational Therapy (AA)
pre-Pharmacy (AA)
pre-Physical Therapy (AA)
Psychology (AA)
Social Work (AA)
Sociology (AA)
Speech Communication (AA)
Surgical Technology (AAS)elect One (if applicable)
Fully Online Program
Select One (if applicable)
Accounting & Business Management (AAS)
IT: Web (AAS)
IT: Programming (Cert.)
Liberal Arts (AA)
Management (AAS)Select One (if applicable)
Change or Correction of Contact Information
New Address:
Former Address:
Proof of residency may be required for some students. If additional documentation is required, a member of the Enrollment Services staff will contact you.
Supporting Documentation
Remove
Remove uploaded file
Change or Correction of Phone Number
New Mobile:
New Home:
Change or Correction of Email Address
New Email:
Electronic Signature:
*
Date:
Friday, 8 November 2024 (EST)
Name:
Type your name to sign this document:
Typing name is equivalent to a handwritten signature
Scan this QR code with your phone:
*
indicates required fields