Name Change Request Form
Instructions:
The student must provide the required documentation requested. The documentation must show the NEW legal name. One of the documents must be a photo ID (State driver’s license, state/military ID card or federal government document, such as citizenship certificate or passport).
In addition, one of the following documents:
*Social Security card (Required and must be signed if receiving federal or state student aid) *Court issued document *Birth certificate *Marriage license *Divorce decree (only first page and last page)
The name change process is for students only. Staff and faculty must go through HR for their name change requests.
Once a student's name has been changed in the system, he/she will receive a letter from the Records Office with a new username and temporary password.
The name change will be processed within 3-5 business days; however, it may take longer during peak periods (ex. graduation, end of quarter, etc.).
MCC Staff procedure: The name change form and copies of the documentation will be scanned and emailed to for processing. The subject line should read “Name Change.” The original documents are then sent to the Records office, FOC 5.
The name change process is ONLY for legal name changes; not to correct a typo in the system. If a typo in a student’s name has been corrected in the system and the username needs to be changed (example: last name was misspelled in the system. It was Hanson instead of Hansen. The username would need to be changed), please contact the Records Associate to update the username in the system and send a letter to the student.
Name Change Request Form
Copies of two forms of documentation showing NEW name are required to process this request.
One of the documents must be a photo ID (State driver’s license, state/military ID card or federal government document, such as citizenship certificate or passport).
In addition, one of the following documents:
*Social Security card (required if receiving federal or state student aid) *Court issued document *Birth certificate *Marriage license *Divorce decree
CURRENT NAME on record:Please type full name
NEW NAME to be changed in the system:
Please type full name
Address:
City: / State: / Zip: / Phone:
Student ID #: / Effective Date of Change:
Student Signature: / Date
REQUIRED WHEN STUDENT DOES NOT SIGN IN PRESENCE OF MCC STAFF
Subscribed to and sworn to before me this day of , 20
(seal)
Notary Public
Signature of MCC Staff Date:
Printed name and location of MCC Staff
______
If the request is made in person, students may complete the form at any Student Services location or at the Records Office**.
Students may also mail the form (must be notarized) and copies of the required documents to:
Metropolitan Community College
Records Office, PO Box 3777, Omaha NE 68103
**Student Services will email the Name Change Request form, along with copies of the required documents to
with Name Change in the subject line. Originals are then sent to the Records office.
R: 12/15