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Name Change Request Form

If you need assistance, call 646-5999. All requests submitted before the 17th of each month's statement.

1. Contact Information:
Department Name:		Department Mail Stop:
Contact Name:		Contact Phone Number:
Contact Email Address:		Date Required:

2. Name Change Information:
Extension:		Current Name:		New Name:		NMSU Email:
Extension:		Current Name:		New Name:		NMSU Email:
Extension:		Current Name:		New Name:		NMSU Email:
Extension:		Current Name:		New Name:		NMSU Email:
Extension:		Current Name:		New Name:		NMSU Email:
Extension:		Current Name:		New Name:		NMSU Email:
Extension:		Current Name:		New Name:		NMSU Email:
Extension:		Current Name:		New Name:		NMSU Email:
Extension:		Current Name:		New Name:		NMSU Email:
Extension:		Current Name:		New Name:		NMSU Email:

3. More Information if needed: