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Change of Name Form

This form must be completed by the student. Employees wishing to change their name need to contact Human Resources.


• First Name:
• Last Name:
• Student ID Number:
• Social Security Number:
• Birth Date:
• E-Mail Address:
• Address (Street):
• Address (City):
• Address (State):
• Address (ZIP):
 
• New First Name:
• New Last Name:
• Reason for Change:

By submitting this form, I certify that the above
change is true and legal with no fraudulent intent.
 


For more information, contact Mustang Central at (307) 382-1677 or mustangcentral@westernwyoming.edu.
 
© 2017 WESTERN WYOMING COMMUNITY COLLEGE
2500 COLLEGE DRIVE, ROCK SPRINGS, WY 82901
(307) 382-1600 or toll free (800) 226-1181

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