Thomas Edison State University     

 

Please complete all required information below. When finished, click the Submit button* at the bottom of the form to transmit it to the University. Please notify your faculty mentor(s) of a change as soon as possible. Keep a copy of this form for your records.

*Important note if making a name change: The registrar's office will need an original or notarized copy of your marriage license, divorce decree or verification of legal name change sent via United State Postal Services. Or, as an alternative to an original or notarized name change document, the registrar's office will accept copies of three (3) separate documents verifying the name change, such as driver's license, Social Security card, passport, bank or pay stub sent via e-mail to registrar@tesu.edu along with the student data change form. Please be aware that the University accepts first and last name information as transmitted to us by the federal government when you submit a FAFSA application. Based on this, we will not allow you to use a first or last name that is not officially recorded with United States Social Security office.

Office of the Registrar
Thomas Edison State University
111 W. State St.
Trenton, NJ 08608

Fax (609) 777-0477

I. Student Information

Student Name*
(use original name if changing)
University ID Number *
Current Course Title(s) and Course Code(s)
Semester  
E-mail Address*


II. Please specify changes required below (fill out only fields where a change is required).

NAME Change (See important note above about documents that are needed when making a name change.)

From:
To:


ADDRESS Change

From:
To:


TELEPHONE NUMBER Change

Home Phone From: To:
Work Phone From: To:
FAX Number From: To:

E-MAIL ADDRESS Change

From: To:

* Required Fields

For Office Use Only:

[ ] Recorded [ ] Filed