Change of Name and/or National ID Number 

Student Information – please print clearly 

This is an application for requesting to change your Name and/or National ID number. 

EMPLID _____________________________________ D.O.B._______/_______/_____________ 

 

Last Name ______________________________ First Name _________________________ Middle Initial ________ 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STUDENT’S SIGNATURE: ______________________________ DATE: _____/______/______ 

 

Phone ( ______ ) _________ --- _________ Email______________________________________@LC.CUNY.EDU 

 

Please note all documents submitted become the legal property of the college and may not be 
surrendered back and or copied. 

 

All name changes must be accompanied by supporting documents and photo identification. 

(i.e., Marriage License, Court Order, Divorce Decree, Birth Certificate, and/or Certificate of Naturalization) 

 

 

PRESENT information on Lehman College Records CHANGE TO 

 

___________________________________ ____________________________________ 

Last Name Last Name 

 

________________________________ _________________________________ 

Middle Initial or Full Middle Name Middle Initial or Full Middle Name 

 

____________________________________ ____________________________________ 

First Name First Name 

 

CHANGE OF NAME DUE TO: (Select all that applies) 

 

Marriage Divorce Court Order Other: _________________________________________ 

 

All change of National ID# requires a signed Social Security Card 

 

Assigned ID / OSIS / Tax ID Number New National ID Number 

_______ - _______ - ______ _______ - _______ - _______ 

 

Are you an Alumni/Alumnus? Would you like to update your information with Alumni Relations? 

FOR OFFICE USE ONLY 

Received By: _______________ Date: _____/____/____ 

Processed By: ______________ Date: _____/____/____ 

Processed for: (select semester) FALL SPRING SUMMER 

Expected Graduation:(select semester) JAN. MAY SEP. 

 

Return this completed form to: 

Office of the Register, Records & Transcripts 

Shuster Hall, Room 106