Name Change (TUG)

Undergraduate Name Change

Name*

First Name

Last Name

Student ID or Social Security #*

Email*

This is a*

Legal Name Change Preferred Name Change

Legal Name Change: Due to Marriage, Divorce, Adoption, or other Legal Name Changes, documentation must be provided. This will be reflected on transcripts and diploma(s).

Preferred Name Change: If you would like APU faculty/staff to call you by a nickname or middle name, documentation is not required but the request is subject Registrar review. This will be reflected in your student portal.

Change my name from*

First Name

Middle Name (optional)

Last Name

Change my name to*

First Name

Middle Name (optional)

Last Name

Placeholder

Status*

Single Married Separated Divorced Widow

Placeholder

Previous Photo Identification Upload*

No File Chosen

File uploads may not work on some mobile devices.

Please attach previous photo identification. Options: Driver's License, State ID, Passport, ect.

New Photo Identification Upload*

No File Chosen

File uploads may not work on some mobile devices.

Please attach new photo identification. Options: Driver's License, State ID, Passport, ect.

Additional Documentation Upload*

No File Chosen

File uploads may not work on some mobile devices.

Please attach one of the following: Social Security card, marriage certificate, legal documentation, etc.

Additional Comments

Signature*

Please type your full name.

Date*

Student Services Center Processing

Registrar Processing*

Record Updated Cancelled - Graduate or Professional Student Cancelled - Los Angeles Pacific University Student Cancelled - Other

Is the student an alumnus?*

Yes No

Note to Student

Please provide explanation if "Cancelled - Other."

Office Notes

Initials *

Date*