Lived/Chosen Name change

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Use this form for changing or adding a Lived/Chosen Name with the Registrar’s Office.
An email notification of this change will be sent to current faculty and staff.

Campus ID Number

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

Note* If you are receiving benefits as a faculty/staff member, you MUST go to Human Resources-Employment Services in Rowe 109 to change forms for your insurance Carriers.

Gender Recognition and Lived/Chosen Name policy can be found online here.
Once your Lived/Chosen names have been updated in the database, you may request a new CMU ID Card. To request a new card you will need to go to the Card Office in the Bovee University Center 209.
The Help Desk will contact you regarding your email, blackboard and any other services they can provide.

New First Name

New Middle Name

New Last Name

Please provide any additional information that may be needed.

The full details of a ticket, including any appropriate circumstances or supplementary information that may aid in resolving it.

Attach documents here if needed.

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

Other Fields

Your name

Your email address

Verification Code