Request to Change the Name of a Center/Institute

Over the life of a Center or Institute the need or interest in changing the name may occur. To request such a name change, complete the information below and forward to the Provost’s Office, PO Box 113175. The name change is contingent upon approval from the Provost.

Note: This form does not save your data; you may enter values before printing, or copy into Word to complete.

Center/Institute Original Name:

Proposed New Center/Institute Name:

Brief Explanation for the Name Change:

Director                                             Date

     Dean                                               Date

Vice-President (as appropriate)                     Date

For Provost’s Office Use Only

Copy to requesting Center: (date)

Copy to Institutional Research: (date)