USVI Public Records

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Albert A. Sheen Campus RR1, Box 10,000 |Kingshill |Virgin Islands |00850-9781 St. Thomas Campus #2 John Brewer’s Bay |St. Thomas | Virgin Islands |00802-9990 CHANGE OF STUDENT PERSONAL INFORMATION Please complete the following information and provide required documentation for changes. If you are providing legal or identity documentation, please deliver this form in person. Request submitted by e-mail, fax, or through third parties will not be accepted. Photo identification must have a clearly reproduced picture to be considered valid when provided. Please allow 3-5 business days for processing. Only complete the areas below that you are seeking to change. Section : Current Name and Contact Information on Record First Name: ____________________________________ Last Name: ____________________________ Student ID: ___ Email Address: _________________ Home Phone: _____________ Cell Phone: _ Mailing Address: ___________________________________________________________________________________________________ Section B: Current Name and Contact Information on Record (Check the applicable box) The University requires a valid Photo ID plus at least one of the following documents (as indicated beside each reason) to support your identity and name. Original or certified true copies of documents must be provided □ Correction or addition to your name (Passport, Social Security Card) □ Correction of Birth (Birth Certificate, Passport) □ Name change by marriage (Marriage Certificate) □ Name change by Divorce (Issued Court Order) □ Return to maiden name (Issued Court order and Birth Certificate) □ Legal Name change (Change of Name Certificate Affidavit issued by the Court) □ Change of Address (No documentation needed) Section C: Requested Amendment(s) to Name and/or Other Information (Name and Date of Birth must match documentation submitted) Use upper and lower case letters, and include hyphens, periods, and spacing as required (e.g., “Manuela Ann-Marie D’Souza). Please note: accents cannot be accommodated. __________________________________________________________________________________________________________________ Last Name __________________________________ ________________________________________________ First Name(s) Prefix __________________________________________________________________________________________________________________ Middle Name (s) / Initial (s) Section D: Change of Permanent Address/ Mailing Address __________________________________________________________________________________________________________________ New Permanent Address __________________________________ New Mailing Address I confirm that I am the student as stated. The Information provided is true and accurate in all respects. _______________________________________________________________________________________ ___________________ Print Name Student’s Signature Date (dd/mm/yy) Rev 6/13/2016 Office Use: Documentation Provided (Check All That Apply) □ Court Order □ Divorce Documents □ Birth Certificate □ Marriage Certificate □ Naturalization Documentation □ Passport □ SSN/Card □ Driver’s License □ Voter’s ID □ Other Legal Documentation _______________________________ Documentation Reviewed and Processed by: ________________________________________ Date : ________________