Address/Email/Telephone Change Form

Directions: Please complete and sign this form online. While it is our preference that this form be submitted through the online form, we also want to present the option of submitting a hard copy. If you would prefer to submit a hard copy, then please print the file located at the bottom of this page, complete and return it to the Office of the Registrar.

Would you like to use your UNCP ID or Last 4 digits of SSN?
Student Information
Are you a student or alumni?
Are you a student worker or current employee?
Address Change
Address Types (please CHECK the address types to be updated)
Address
Email Change
Email Types (please CHECK the email type to be updated)
Telephone Change
Telephone Types (please CHECK the telephone type to be updated)
Signature

I assume responsibility for any consequences or problems that may occur as a result of changing of my name. There is no intent on my part to defraud the University of North Carolina at Pembroke.

Sign above

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