CommentsThis field is for validation purposes and should be left unchanged.Applicant InformationMember NumberReason for Name Change: Marriage Divorce Other Applicant Previous Name(Required) First Last Applicant Current Name(Required) First Last Applicant Social Security Number(Required)Legal Proof of Name Change(Required)This can be an updated ID, court order, or other legal document.Max. file size: 100 MB. Consent(Required) I understand that completion of this form changes the name(s) for my existing membership number and does not in any way alter the ownership or obligation of that membership. This includes any part of the previously signed membership application recorded under my previous name.Applicant Electronic Signature (Full Name)(Required)
