Registrar Change of Information Form

Current Name*
First Middle Last Suffix
Date of Birth*
Do you have a change of name?*
- No
- Yes
Former Name*
First Middle Last Suffix
You will need to attach an image of your Social Security Card for name change verification.*
Accepted file types: pdf, png, jpg, Max. file size: 64 MB.
Do you need to correct your Social Security number or name in our system?*
- No
- Yes
You will need to attach an image of your Social Security Card for name change verification.*
Accepted file types: pdf, png, jpg, Max. file size: 64 MB.
Do you know your Faulkner ID number?*
- Yes
- No
If you need to submit additional information or any explanations along with the above changes. Please email the Registrar's office directly at registrar@faulkner.edu .
Faulkner ID Number*
SSN*
Contact Number*
Alternate Number
Email*
Enter Email Confirm Email
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Signature*
- I agree that the above information is accurate, and that I am the student whose name appears on this form
Name
This field is for validation purposes and should be left unchanged.

Form has been tagged under:Registrar

Introduction