Student Information Change Request Form                               Green River Logo
Instructions:  Complete this form online, print it, attach required documentation and submit to Enrollment Services for processing

1. CURRENT Information:
Name:  Last   First  MI
Student ID Number (SID):     
2. ADD Social Security Number for financial aid and/or transcript purposes:
(In compliance with state/federal requirement, disclosure of the SSN may be authorized for the purpose of state and federal Financial aid, Hope/Lifelong Learning tax credits, academic transcripts, assessment or accountability research.)
Add Social Security Number (SSN):  

(Documentation required, social security card and picture ID.)
3. CHANGE Information To: 
  • Name:   Last   First  MI

(Documentation required, i.e. drivers license, marriage certificate, or divorce decree.)
  • Mailing Address: Student may change address online at Online Services

    Address:
    City:
    State:    
    Zip Code: 

(Documentation required, i.e. drivers license.)
  • Phone Number: Student may change phone number online at Online Services

     Day:   
     Evening: 

(Documentation required, i.e. drivers license/picture ID.)
4. Have you already applied for Graduation/Diploma?  Check one:  Yes   No  

5. Student Signature Required:     Date:

For Office Use Only: 

Student under two SID's, change:    From:   

                                             To:    

 Processed by:     Date: