Former Student Information Update

This form is for former NC State students, who no longer have active campus (MyPack) credentials, who need to request an update to their name, gender or date of birth in the NC State system.

This form is used to update personal information on your official student record. Please indicate the change below and make sure you provide proof of this change.

If you are a current NC State student, with active MyPack credentials, please submit the appropriate secure request form from the Forms Directory.

Your Current Information

First Name *

Middle Name

Last Name *

Suffix

Date of Birth *

Email Address *

Phone Number

Previous NC State Information

This information is used to identify your record in our system so please provide what is applicable or you remember.

Previous Last Name (if applicable)
Your last name when last enrolled at NC State if different from above.

NC State Student ID Number, if you remember it (do not guess)

NC State Unity ID, portion of your NC State Email Address before the @ symbol

Name Update

Check this box to update your name

If you have worked for NC State University during the last year, you must provide a Social Security Card to initiate a name change. Your new name must match your Social Security Card or your name will revert to the name that currently appears on your Social Security Card.

Updated First Name

Updated Middle Name

Updated Last Name

Updated Suffix

Gender Update

Check this box to update your gender

Updated Gender

Date of Birth Update/Correction

Check this box to update your Date of Birth

Updated Date of Birth

Material Upload

A LEGAL DOCUMENT MUST BE PRESENTED TO CHANGE ANY OF THE ABOVE INFORMATION. *

Select which document you will be uploading.

Social Security Card (NOTE: must be provided if employed by NC State in the last year.)

Driver's License or State Issued ID Card

Certified Copy of Court Order granting name change

Marriage Certificate or Divorce Papers (NOTE: must reflect the official name change)

Please upload the appropriate material listed above for your personal information change request. *

Person Status (Hidden) of Former Student