This form can only be used for address changes. name changes, and phone number changes for BOE employees only. Please note this form is NOT for CITY employees (UAW, MAA, CUS).
All name changes will need supporting documentation.
Due to electronic signature regulations, once this form is submitted, the entry cannot be changed. However, you may submit another form if this information changes.
Forms and documentation must be submitted by noon on the Wednesday prior to payroll in order to go into effect that pay period.
Name Change Acknowledgements/ Next Steps
Please note the following:
For Certified Staff (required), please update the following with your new name:
For Certified Employees only: Update your address with the Connecticut State Department of Education. Login to the Connecticut Educator Certification System (CECS). Under Profile, select Personal Info. Within the Contact Information Tab, make any changes to your contact information and click Update.