NW-SCC Change of Information Form

Students may use this form to update basic information on their student record. Please contact the Admissions Office if you need to make a change to your SSN.

Check all options below for which you are requesting a change:

Student Identification Number*

Corrected Date of Birth

Are you a student worker employed by NW-SCC?

Yes

Student's Current Name (please list last name, first name, middle name, and maiden name if applicable)*

Former Name (if applicable)

New Address (Include Street or PO Box, City, State, Zip, and County)

New Telephone #

New Email Address

Emergency Contact Information

Name

Address

Telephone #

Current Student Information