Change of Name or Address

NOTE: A change in residency requires additional documentation. Forms are available in the Admissions Office.

A change in name requires a copy of marriage license, divorce decree, or other legal evidence.

BSC ID Number(Required)

Name(Required)

First Middle Initial Last

Type of change(Required)

Name After Change(Required)

First Middle Initial Last

Marital Status(Required)

Old Address(Required)

Street Address City State ZIP Code

New Address(Required)

Street Address City State ZIP Code

Old Phone(Required)

New Phone(Required)

Old County(Required)

New County(Required)