National American University

Use this form to change the following:  address, major, social security number, or name.
Any items that are marked with an asterisk (*) are required.

* Student Name * Date
* Student ID #:  * Home Campus

ADDRESS CHANGE

Old Address
City
State Zip
Phone Number  
E-mail address
New Address
City
State Zip
Phone Number  
E-mail address

PROGRAM CHANGE
(Transfer will move all academic information from one program to another. Do Not transfer any program you intend to complete. Add will allow you to track more than one program.)

Transfer from: MBA    MM    MSN Emphasis: 
Transfer to: MBA    MM    MSN Emphasis: 
Add additional program: MBA    MM    MSN Emphasis:

SOCIAL SECURITY NUMBER CHANGE
Incorrect Number Correct Number

NAME CHANGE

Previous Full Name

New Full Name

Explanation
In order to change name or social security number, this form along with a copy of the legal document must be mailed or faxed to the Office of the Registrar at the address/fax number indicated below

NAU - Distance Learning
5301 S Highway 16, Suite 200
Rapid City, SD 57701
FAX (605) 394-5082

National American University is accredited by The Higher Learning Commission
and a member of the North Central Association - www.ncahlc.org
Copyright 2011 - National American University
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