WEST LIBERTY UNIVERSITY

DATA CHANGE REQUEST FORM INSTRUCTIONS: Complete all requested information. Complete each section applicable to current request (s). If you are CHANGING YOUR NAME please mail or fax documentation to the Registrar's office. For name change substantial documentation is required such as: Divorce Decree, Marriage Certificate, or Court Order before any records will be offically changed. ONLY CHANGE THE DATA THAT NEEDS CHANGED ON YOUR RECORDS. Fax 304-336-8220
* Required





















Never submit passwords through Google Forms.