Change of Student Information Form
This is to change items like address, phone number, or name in your Student records. Change of Residency requires a separate form: https://forms.templecollege.edu/252505778863065
Name
*
First Name
Last Name
TC Student ID
*
should be a 6 to 7 digit number
What Information would you like to change?
*
Address
Contact Number
Personal Email
Social Security Number
Name
Emergency Contact:
Update Address
Please note: If you wish to request a change of residency status form out-of-district to in-district, you must fill out a Change of Residency form and qualify for in-district status: https://forms.templecollege.edu/252505778863065
Which address are you changing?
*
Physical
Mailing if different from your Physical Address
New Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
New Mailing Address if Different From Your Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
New Home Number:
Please enter a valid phone number.
Format: (000) 000-0000.
New Work Number
Please enter a valid phone number.
Format: (000) 000-0000.
New Cell Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
New Personal Email
*
example@gmail.com
Social Security Number Corrections:
Please note: For a Social Security Number changes you must provide your Social Security Card.
Correction of Social Security Number: Correct SSN:
*
SSN
Upload Social Security Card
*
Browse Files
Drag and drop files here
Choose a file
proof of Social Security Number correction
Cancel
of
Name Change:
Please note: For a name change you must provide one of the following approved documentation; Marriage License, Divorce Decree, Court Order, Driver's License, State ID card or Social Security Card.
Previous Name
*
First Name
Last Name
Current Name
*
First Name
Last Name
Upload supporting document
*
Browse Files
Drag and drop files here
Choose a file
Acceptable documents: Marriage License, Divorce Decree, Court Order, Driver's License, State ID card or Social Security Card.
Cancel
of
New Emergency Contact Person
*
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
I certify the information I have given on this form is true and correct to the best of my knowledge.
By entering my name below, I certify that all information provided is true and complete. I understand that my electronic signature has the same legal effect as a handwritten signature and authorizes Temple College to review and verify the information submitted.
*
Enter your name to show you understand and agree
Today's Date that form has been signed
*
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