Student Record Update

Records and Registration Office
North Hennepin Community College
7411 85th Ave. North
Brooklyn Park, MN 55445-2299
Registration@nhcc.edu

This form cannot be used for change of name or Social Security Number. To do so, please contact the Records & Registration Office.

This form cannot be used for admissions to the following programs:

Please contact the Advising Center for information regarding admissions to these programs.

Indicates required field

Student Information

First Name

Last Name

Previous Name

Date of Birth

Phone Number

Email Address

Street Address

City

State

Zip Code

New Major

Previous Degree(s)

Associates

Bachelors

Graduate or Professional

Previous College(s) Attended

Name of Institution	City	State
Name of Institution	City	State

Proof of Identification

Government-issued ID is required. Please submit both front and back

Maximum 2 files.
10 MB limit.
Allowed types: gif, jpg, png, svg.

Signature

Student ID/Password

I would like my Student/TechID number and password emailed to me. (Your password will be reset.)

Student Signature

Sign above