Change of Name/Address Form

SSN/Student Number
Name
   
NAME CHANGE
Previous Name
Current Name
   
ADDRESS CHANGE
Address
City
State
Zip (example - 35470)
Phone
Email

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Equal Opportunity Institution:  The University of West Alabama is an equal opportunity institution whose programs, services, activities, and operations are without discrimination as to sex, race, color, or national origin, and are open to qualified handicapped persons.

 

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