AGS Student Information Change Form

What is your name?(Required)

First Last

What is your Montreat College email address?(Required)

Who is your academic advisor?(Required)

Elizabeth Boling

Matthew Engheta

I don’t know

What student information do you need to change?(Required)

My name has changed

My mailing address has changed

My telephone number has changed

My employer has changed

My personal email address has changed

Name Change

Additional documentation will be required to complete the legal name change. An updated Social Security Card and legal document with full legal name can be provided to assigned academic advisor.

Your old legal name(Required)

First Middle Last

Your new legal name(Required)

First Middle Last

Reason for the change(Required)

Change of Address

New Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

New N.C. County(Required)

Change of Telephone Number

Which phone number(s) have changed?

Home Phone Number

Work Phone Number

Cell Phone Number

Home Phone Number(Required)

Work Phone Number(Required)

Work Phone Number Extension

Cell Phone Number(Required)

Change of Employer

New Employer(Required)

Change of Personal Email Address

New personal email address(Required)

Electronic Signature

I agree and acknowledge that this document can be executed electronically and it is binding in every way as if signed by my hand.

Student Electronic Signature(Required)

Student Electronic Signature – Date(Required)

Month

Day

Year

Comments

This field is for validation purposes and should be left unchanged.

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