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Name Change Affidavit (PDF)
Your name of record is the name listed in the Columbia University Student Information System. To change your name, use this form.
IMPORTANT: This form cannot be submitted electronically. Please type in the required information, print, sign and mail to the appropriate address. This form must also be notarized by a Notary Public.
With your name change affidavit, you should send photocopies of the following:
Office of the Registrar – Student Service Center
205 Kent Hall, MC 9202
1140 Amsterdam Avenue
New York, NY 10027
Registration & Financial Services @ CUMC
650 W. 168th Street
Unit 45, Black Building Room 141
New York, NY 10032