Staff Address & Name Change Form
Page 1 of 1
Location
1.
Legal first name (before name change)
*
2.
Legal last name (before name change)
*
3.
Employee type
*
Employee type
*
Certificated
Classified
Administration
Substitute
4.
Work email address
*
5.
Location
*
--Please Select--
AIM High School
Cascade View Elementary
Cathcart Elementary
Centennial Middle School
Central Primary Center
Dutch Hill Elementary
Emerson Elementary
Glacier Peak High School
Little Cedars Elementary
Machias Elementary
Operations and Maintenance
Parent Partnership Program
Riverview Elementary
Resource and Service Center
Seattle Hill Elementary
Snohomish High School
Totem Falls Elementary
Transportation
Valley View Middle School
6.
What are you changing?
*
What are you changing?
*
Residence address (see question 7)
Mailing address (see question 8)
Phone number (see question 9)
Name (see questions 10-13)
7.
New residence address
Street
City
State
Zip code
Phone number
Is this your mailing address?
New residence address
--Please Select--
Yes
No
8.
New mailing address
Street
City
State
Zip code
New mailing address
9.
New phone number
Home phone (including area code)
Cell phone (including area code)
New phone number
10.
New name (person 1)
Family member(s) or student(s) currently at Snohomish School District
First name
Last name
Employee or student
New name
--Please Select--
Yes
No
--Please Select--
Employee
Student
11.
New name (person 2)
Family member(s) or student(s) currently at Snohomish School District
First name
Last name
Employee or student
New name
--Please Select--
Yes
No
--Please Select--
Employee
Student
12.
New name (person 3)
Family member(s) or student(s) currently at Snohomish School District
First name
Last name
Employee or student
New name
--Please Select--
Yes
No
--Please Select--
Employee
Student
13.
New name (person 4)
Family member(s) or student(s) currently at Snohomish School District
First name
Last name
Employee or student
New name
--Please Select--
Yes
No
--Please Select--
Employee
Student
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