NAME CHANGE REQUEST

Student Information

Name as it currently appears in COD records:

Last Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
First Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Middle Namefield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Student ID*field type single line
Must be 7 digits. Example 0123456
Input blocked. Maximum character limit of 4000 characters reached.
College Email*field type single line
example@mycod.us
Input blocked. Maximum character limit of 4000 characters reached.

Scan supporting documentation and save in an allowed format (JPEG, PDF, TIFF). Use the Supporting Documents Upload in the A&R Forms menu on the Student Portal to submit.
- Copy of photo ID showing previous name
- Copy of valid photo ID, such as driver's license, state ID card, or passport showing your new name. (Enlarge and lighten copy so it is easier to read)
- Copy of Social Security Card issued to your new name. (Enlarge copy so it is easier to read)
- A legal, court filed document showing support for name change, such as marriage license, divorce decree or court order.

Last Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
First Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Middle Namefield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Your Web Advisor user name will not change.

I AGREE*field type checkbox
I AGREEI hereby certify that the information provided in this form is true and accurate.
Student Full Name*field type single line
This Constitutes as e-signature.
Input blocked. Maximum character limit of 4000 characters reached.
Date*field type date
Please allow up to 10 business days for processing.