Change Legal Name

Do you have a Campus ID# (Example 261661)

Yes No

Enter your Campus ID Number

Enter the LAST FOUR digits of your Social Security Number ONLY (Please DO NOT enter the full SSN)

Preferred Email Account

Are you currently, or have you been employed at CMU in the last 13 months?

Yes No

You were/are?

Faculty Staff Student Assistant Grad Assistant

Reason for Change?

Legal Name Change Change after Marriage Change after Divorce Other

"Other" please explain

New First Name

Previous First Name

I have a new middle name.

Select "No" only if you don't have a middle name in your new name.

Yes No

New Middle Name

I have a previous middle name.

Select "No" only if you don't have a middle name in your previous name.

Yes No

Previous Middle Name

New Last Name

Previous Last Name

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File attachments associated with the ticket.

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I agree to abide by CMU Policies regarding the use of computing resources. (link below)

Yes No

CMU Policies regarding the use of computing resources.

Registrar's Office, Warriner Hall 212, Mount Pleasant MI 48859
Phone: (989) 774-3261 Email: records@cmich.edu Fax: (989) 774 3783

Your name

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