Change of Personal Information Form

For faster processing, NLU ID is required, however, if you do not have your NLU ID # please enter the last four digits of your social security number.

NLU ID:

Last 4 digits of your Social Security Number: *

Current Name: *

New Name: *

New Address: *

New City: *

New State: *

New Zip: *

New Phone: *

New Email: *

Please upload at least one document as proof of name change or address change.: *

A copy of the following documents will be accepted as proof of name change or address change:

Birth Certificate
Marriage License
Driver's License
Divorce Decree (including page authorizing name change)
Judicial Decree (specifically authorizing name change)
Naturalization Documents

Change of Personal Information Form

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