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Name & Address Change

The NAME AND ADDRESS CHANGE FORM (pdf) may be used for multiple purposes. Current students may use it to change their name, and/or to update a permanent and/or local mailing address in the student information system.  


  • Complete the appropriate sections of this form as they apply to your situation. 
  • Don't forget to sign the form! 


Helpful Tips: Students who are changing their name must provide supporting documentation with their form. Acceptable forms of documentation for a name change include a copy of the Social Security Card, Valid Driver's License, Marriage Certificate, or Court Order.


Submission Information

Submission of any form is contingent upon student verification (Photo ID and/or signature). 

Remember that the student is ultimately responsible for all information concerning his or her records. Many processes are time-sensitive. Please plan accordingly.

This form can be downloaded and printed out using Adobe Acrobat Reader.  It may be submitted in person at the front desk of the Barlow Hall.  It may also be faxed, mailed, or emailed as an attachment to:

Office of the Registrar
Longwood University
201 High Street
Farmville, VA 23909

Fax: 434-395-2252
Email: registrar@longwood.edu