Address/Name Change Request Form

Address/Name Change Request Form
Please complete all required sections and submit the form. Please allow 2-3 business days for processing.
Current Full Name on Record:

First NameMiddle NameLast Name
Student ID Number:
WGTC Student Email:
example@example.com
Which change are you requesting?
Complete This Section for Address Changes:
New Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County:
Home Phone Number:
Cell Phone Number:
Do you give permission for WGTC to contact at the telephone numbers provided via any means, including text messaging or voice?
Complete This Section for Name Changes:
Please upload below a copy of one of the following with a name change request:Driver’s License, Social Security Card (must be submitted in person), Marriage License, Birth Certificate, Immigration Records, Divorce Decree, Court Order, or Passport.
Please upload your selected documents.

Browse Files

Cancelof
New Name:

First NameMiddle NameLast Name
By signing below I acknowledge that I have read and understand this form in its entirety:
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: