Santa Clara University

Office of the Registrar

Request for Name Change to Add Married Name

This form is solely for the addition of the MARRIED name.  For all other name changes complete and follow the directions for the "Name Change For Other Than Marriage Form" also available on the Forms page on the Office of the Registrar web site. Go to: www.scu.edu/registrar


 

Request for Name Change to Add Married Name

Date:*

College:*

Undergraduate    Graduate    Law    

Student ID: (example: W0123456)*

Name as Currently Listed: (Last, First, MI)*

College:*

Undergraduate
Graduate Business
Graduate Counseling Psychology
Graduate Engineering
Graduate Pastoral Ministries
LAW

Contact Email Address:*

Acknowledgement:*

I acknowledge

By checking this box, I acknowledge that it is my responsibility to check my listed contact e-mail address within 24 hours of submission of my request for confirmation from the Office of the Registrar of the change. The Office of the Registrar will respond within three business days of this submission.  I further understand that my petition will not be submitted to the Office of the Registrar if I do not check this box.

Contact Phone Number:*

() -

Change Name To:*

(Last, First, Middle)

Reason: Marriage*

Yes    No    

If answering NO  than complete the Name Change Form for Other Than Marriage located at www.scu.edu/registrar

 

Are you currently enrolled?*

Yes
No

If no, list last date of attendance (month/year):

Confirmation:*

Please select at least 1
I affirm that the above submitted information is true.