Record Change Request

All changes to records must be submitted through this form. Please fill out this form to request any changes to a record(s) in the database. Thank you for your cooperation.

* indicates a required field.

       
* ID #
*If multiple ID's, please list all ID's in the text box provided below.
* First Name  
* Last Name  
  Record Change Primary Manager Change
Add to President's Letter
Remove from President's Letter
Address Change
Phone Number Change
Email Change
Employment Change
Spouse Added
Make Inactive (Alumni Excluded)
Deceased
Other
 
  Other:  
* Change (as descriptive as possible)
 
  Multiple ID #'s
 
* Requested by  
* Date Requested  
* List emailed with changes Yes
No
Email your list/document to Devra Andersen in addition to filling out this form.