Change of Name

Change of Name Form Information: To change the legal name maintained on the student's official BCC&S record, graduate students must complete this form and submit it with supporting documentation to the Office of the Registrar. If you have changed your mailing or permanent address, please complete and submit a “Change of Address Form” to the Office of the Registrar. If you intend to graduate at the end of the current term, contact the Office of the Registrar. Requirements: To obtain the name change, you must attach a copy of an official legal document containing the changed name: (e.g., Driver’s License, Social Security Card, Military ID, Vehicle Registration, Divorce Decree, Passport, etc.). Current name under which you are registered at BCC&S:

Last name: _______________________ First name:_________________________ MI.___ Check one: Change Primary Name ___ Diploma Name___ Primary and Diploma Name___ New Legal Name Must be completed in full. Please print clearly: Last Name: __________________________________________ First Name: __________________________________________

 

Check if Applicable: Middle: _____________________________________________ Maiden: _____________________________________________ Signature: Student Signature: ______________________________________ Date: ____ Berean Christian College and Seminary, Incorporated 2022