Admissions and Records (559) 278-2261
Student Information
Update Form
Complete only box(es) you wish to change
Name:
Student ID #:
Phone Number:
Last First Middle
Name as
shown on file:
Last First Middle
Legal Name Change
Social Security Number
As Shown on Social Security Card or ITIN letter
MUST Attach Copy of Drivers License or Passport and Social Security Card or ITIN letter
Current Number
Number on File
As Shown on Current Drivers License or PassportDate of Birth on File
Gender
Male Female
Gender on File
Male Female
As Shown on Current Drivers License or Passport
MUST Attach Copy of Drivers License or Passport
Last Enrolled:
Checklist:
Updated By:
Date:
Office Use Only
Form can be mailed to: Academic Records, 5150 N. Maple Ave., M/S JA57, Fresno, CA 93740
(no faxes accepted)
IMPORTANT NOTE: If you are a current employee at Fresno State, please visit
Human Resources/Payroll, Joyal Room 211 in-person.
3/3/2017
MUST Attach Copy of Drivers License and Social Security Card or Passport
MUST Attach Copy of Drivers License or Passport
Last First Middle
New Legal
name (as shown
on SSN or
Passport):
(Primary and preferred name will be updated)
Date:Student Signature:
Birthdate
