COMPLETE THIS FORM, PRINT OUT, SIGN, MAIL TO:
Registrar’s Office • University of the Pacific McGeorge School of Law
3200 Fifth Avenue • Sacramento, CA 95817

MAILING ADDRESS / NAME CHANGE REQUEST

Date
        
Student ID
OR
Social Security No.
Name: Last
First
Middle
Address
City
State
Zip
Phone: Home
Business
Cell
E-mail
Class Year
If not now enrolled:
 My last date of attendance OR Date of graduation was

Signature _____________________________________________________

Address Change:

New Address
City
State
Zip
New Phone: Home
Business
Cell
New E-mail
 
Name Change: New legal name on record
(Sign new name on signature line in section above)

 

Office Use Only: Computer ____________________________________________________________________________________