HomeStudent Record Update FormLoading...If you are a current student, please submit the form using this link.Students, faculty, staff and alumni should use this form to update student contact and employment information with Relay. This information may impact critical details related to students’ academic, financial, enrollment, and certification status so please ensure the accuracy of the information which you are sharing prior to submission. The Registrar’s Office may reach out with any questions or for additional details. You will receive automated email confirmation that your request has been processed within 2 weeks of submission. Thank you for keeping us updated!Some student record information cannot be updated via this form (e.g. program, major, etc.). Below please find links to the appropriate forms to:Update Major/Concentration/Area of StudyWithdrawing or taking a Leave of Absence from your Relay programChange program or reenroll at RelayChange your email if you DO NOT have an @student.relay.edu email addressPlease note: submitting multiple requests will result in longer processing times. If you are unsure if you have submitted your request or would like an update on your outstanding request, please contact us via support@relay.edu.Please confirm your role at RelayEnrolled StudentAlumniProspective StudentLeadership Conference AttendeeFaculty/StaffOtherIf you are submitting more than 5 requests, please submit a bulk update form instead. Please contact the Registrar's Office for access to the form.Please share your Relay email (for students, this email is your Microsoft login credentials)Your Relay emailYour full namePlease enter the student's first name as it currently appears in Relay's systemsYour First NamePlease enter the student's preferred first name as it currently appears in Relay's systemsYour Preferred NamePlease enter the student's last name as it currently appears in Relay's systemsYour Last NameWhat is the student's Relay email?Please paste the web URL of the student's SIS page that requires adjustmentWhat is the student's Relay Student ID?Please reach out to Relay’s Office of Admissions and Enrollment (OAE) at support@relay.edu or by phone at 212-288-1888 prior to the beginning of your enrollment at Relay.Please reach out to your Leadership program staff via support@relay.edu to update your student record.How can we assist you?You should see your Relay Student ID in one of the boxes below (read-only).If your Relay Student ID above is blank or incorrect, please enter it here. Your Relay Student ID can be found on your Student ID, student academic progress (SAP) emails, or you can reach out to support@relay.edu.Please provide your academic advisor's emailPlease select your current or most recently attended campusAtlantaBaton RougeChicagoConnecticutDallas-Fort WorthDelawareDenverHoustonIndianapolisLeadershipMemphisNashvilleNew OrleansNew York (Rochester Cohort)New York CityNewarkOnlinePhiladelphia & CamdenSan AntonioWashington, D.C.What information should be updated?What information should be updated?Update personal contact information (e.g. address, phone number, preferred name, legal name, date of birth)Update your employment and/or partnering organization informationUpdate other information not listed elsewhereUpdate Student Contact InformationWhat contact information would you like to update?What contact information would you like to update?Update Preferred NameUpdate Gender Identity and/or Personal PronounsUpdate Legal NameUpdate Date of BirthUpdate Phone NumberUpdate Mailing AddressUpdate Email AddressPlease list the name by which you would prefer to be referred to in all Relay communications:Please indicate your current gender identityFemaleMaleNon-binary/third genderOptional: Provide your personal pronounsOptional: Provide your personal pronounsHe/HimShe/HerThey/ThemThey/HeThey/SheZe/Zir/ZirsNo Pronouns (Use Preferred Name)OtherIf other, please specify:Please indicate if your first or last name have legally changedFirst NameLast NamePlease attach an official government ID with your legal name or proof of your change of name (e.g. driver's license, passport, marriage certificate, etc)If you have an @student.relay.edu email address, would you like your email updated to reflect your change in name?YesNoN/APlease indicate your correct date of birthPlease indicate your correct date of birthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember1234567891011121314151617181920212223242526272829303120242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Please attach an official government ID with your birthdate clearly labeled (e.g. driver's license, passport, etc.)Please indicate your updated phone numberPlease indicate your updated mailing addressPlease indicate your updated mailing addressCountryStreetCityRegionPostal CodeWhat would you like your email changed to? Please note: Students with an @student.relay.edu email will only have their secondary email updated.Update Employment Information A change in employment and/or membership may impact your Relay enrollment status. Click here to learn more. If you have questions, please contact the Registrar’s Office at support@relay.edu or sign up for an appointment. If you have a new mentor teacher, please also complete the mentor teacher update form.What type of change in employment are you requesting?What type of change in employment are you requesting?Loss of employmentNew employmentUpdate to current employmentLoss of partnering organizationNew partnering organizationWhat is the name of the school you left?What was your last date of employmentWhat was your last date of employmentJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember1234567891011121314151617181920212223242526272829303120202021202220232024What is the name of the school you are joining or are currently employed at?What is the address of the school?What is the address of the school?CountryStreetCityRegionPostal Code Did the state in which you are employed change? Are you now or will you be teaching in a different state while enrolled at Relay?In compliance with the U.S. Department of Education regulations (34 CFR §668.43(a)(5)(v) and 34 CFR §668.43(c)), when an enrolled student notifies Relay of a change in their "location", Relay shares information about whether the program in which the student is enrolled meet educational requirements for licensure in the state to which the student is relocating. Because Relay's programs require that students are employed in a school-based position while enrolled, Relay uses the state of employment while enrolled to determine students' location. If the program in which you enrolled does not lead to licensure in the state in which you will be located, or if Relay has not yet made a determination, you will receive an email. Visit www.relay.edu/policies for more details.YesNoWhat is the new state in which you are teaching/will be teaching?AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWhich of the following best describes your current position? (select one)Apprentice/Associate TeacherAssistant PrincipalCo-TeacherContent Area CoachDean/Director of InstructionDepartment or Grade Level ChairFull-Time TeacherInstructional LiaisonLead Teacher (managing teachers)Mentor TeacherPrincipalPrincipal FellowTeacher in ResidenceManager of PrincipalsParaprofessional/ParaeducatorTutorBehavioral SpecialistAssistant TeacherOtherPlease indicate what your current position is.What was your first date of employment?What was your first date of employment?JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember123456789101112131415161718192021222324252627282930312021202220232024Primary Grade LevelPre-KK12345K-567895-91011129-12Primary SubjectAll SubjectsBiologyChemistryEarth SciencePhysicsScienceEnglish as a Second LanguageEnglish Language Arts (ELA)MathReadingWritingSocial StudiesArtDo you teach and/or lead another grade level and subject area?Do you teach and/or lead another grade level and subject area?YesNoSecondary Grade LevelPre-KK12345K-567895-91011129-12Secondary SubjectAll SubjectsBiologyChemistryEarth SciencePhysicsScienceEnglish as a Second LanguageEnglish Language Arts (ELA)MathReadingWritingSocial StudiesArtDo you teach and/or lead another grade level and subject area?Do you teach and/or lead another grade level and subject area?YesNoTertiary Grade LevelPre-KK12345K-567895-91011129-12Tertiary SubjectAll SubjectsBiologyChemistryEarth SciencePhysicsScienceEnglish as a Second LanguageEnglish Language Arts (ELA)MathReadingWritingSocial StudiesArtWhat partnering organization are you leaving?Teach for AmericaNew York City Teaching FellowsOtherPlease indicate which partnering organization program you are leavingWhy did you leave your partnering organization?What was the end date of your affiliation with this partnering organization?What was the end date of your affiliation with this partnering organization?JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember1234567891011121314151617181920212223242526272829303120202021202220232024What is your new partnering organization?Teach for AmericaNew York City Teaching FellowsOtherPlease indicate your new partnering organizationUpdate Other InformationPlease share the information you would like us to update:Review Submitted InformationI verify that all of the information I have submitted on this form is true and complete. This includes that I am the individual self-identified on this form and that I am a current or former student of Relay Graduate School of Education:Staff Update FormWhich campus does your request pertain to?AtlantaBaton RougeChicagoConnecticutDallas-Fort WorthDelawareDenverHoustonIndianapolisLeadershipMemphisNashvilleNew OrleansNew York (Rochester Cohort)New York CityNewarkOnlinePhiladelphia & CamdenSan AntonioWashington, D.C.What type of information would you like to update?Administrative withdrawalChange of employment and/or partnering organizationChange of start or end datesStudent biographical and/or contact informationOther missing or incorrect informationPlease direct the student whose information you’re trying to edit to complete this form. We are unable to edit a student's biographical or contact information except at the explicit request of the student.Change of a Student's Employment and/or Preparation ProgramWhich of the information below would you like to report?Which of the information below would you like to report?Loss of EmploymentNew EmploymentLoss of Partnering OrganizationAddition of Partnering OrganizationWhat is the effective date for the student’s change of employment or partnering organization? What is the effective date for the student’s change of employment or partnering organization? JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember1234567891011121314151617181920212223242526272829303120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044Please provide the name of the school that the student was previously employed atPlease provide the name of the school that the student is currently employed atPlease provide the address of the school that the student is currently employed atPlease provide the address of the school that the student is currently employed atCountryStreetCityRegionPostal Code Did the state in which the student is employed change? Are they now or will they be teaching in a different state while enrolled at Relay?In compliance with the U.S. Department of Education regulations (34 CFR §668.43(a)(5)(v) and 34 CFR §668.43(c)), when an enrolled student notifies Relay of a change in their "location", Relay shares information about whether the program in which the student is enrolled meet educational requirements for licensure in the state to which the student is relocating. Because Relay's programs require that students are employed in a school-based position while enrolled, Relay uses the state of employment while enrolled to determine students' location. If the program in which you enrolled does not lead to licensure in the state in which you will be located, or if Relay has not yet made a determination, you will receive an email. Visit www.relay.edu/policies for more details.YesNoWhat is the new state in which the student is teaching/will be teaching?AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWhich of the following best describes the student’s position?Apprentice/Associate TeacherAssistant PrincipalCo-TeacherContent Area CoachDean/Director of InstructionDepartment or Grade Level ChairFull-Time TeacherInstructional LiaisonLead Teacher (managing teachers)Mentor TeacherPrincipalPrincipal FellowTeacher in ResidenceManager of PrincipalsParaprofessional/ParaeducatorTutorBehavioral SpecialistAssistant TeacherOtherPrimary Grade LevelPre-KK12345K-567895-91011129-12Primary SubjectAll SubjectsBiologyChemistryEarth SciencePhysicsScienceEnglish as a Second LanguageEnglish Language ArtsMathematicsReadingWritingSocial StudiesWhat partnering organization should be added to the student's account?Bronx Talent InitiativeDenver Math and Literacy FellowsMan Up Teacher FellowshipNew York City Teaching FellowsNew York City Teaching CollaborativeTeach for AmericaTeach for America Colorado Launch FellowshipOther (write in)What partnering organization should be added to the student's account?Is this student an alumni of the partnering organization?YesNoWho initiated the termination from the partnering organization?StudentPrep ProgramTechnical Error (Student was never part of the prep program)OtherWhat is the name of the partnering organization?Teach for AmericaNew York City Teaching FellowsOtherPlease indicate which partnering organization the student is leavingAdministrative WithdrawalPlease note: Retroactive withdrawal date requests for students will be reviewed but is not guaranteed. The Registrar's Office will review the student's activity in Canvas and cross reference it with the effective date of request and any communication with the student in Zendesk. If the student has been active in Canvas, we will not be able to process the retroactive administrative withdrawal date.If the withdrawal date is prior to a past census date, you MUST contact Student Financial Services (SFS) explaining why the student’s charges should be waived for a given term.What should the effective date of the withdrawal be?What should the effective date of the withdrawal be?JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember12345678910111213141516171819202122232425262728293031202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044Why is the student being withdrawn?Failure to pay tuitionFailure to meet employment requirementsFailure to meet matriculation requirementsFailure to meet local immunization requirementsFailure to meet local certification requirementsFailure to submit withdrawal paperwork after initiating a withdrawalFailure to meet attendance requirements and/or persistent absenceOther substantive violations of Relay’s policies, procedures, or safety rules, including but not limited to violations of the academic honesty, code of conduct, or gender-based misconduct policiesAt the request of their campus Dean’s officeOtherPlease specifyChange in Start or End DateAre you reporting a change in start and/or end date?Are you reporting a change in start and/or end date?Start DateEnd DateWhat should the student's start date be?What should the student's start date be?JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember123456789101112131415161718192021222324252627282930312020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044What should the student's end date be?What should the student's end date be?JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember12345678910111213141516171819202122232425262728293031202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044Who has approved this change in start and/or end date?What is the reason for this change?Missing or Incorrect InformationIf data is incorrect, what appears NOW? If data is missing, please enter N/APlease enter what SHOULD appear.Review InformationIs there anything else you need to note about this request that was not captured elsewhere in this form?I verify that all of the information I have submitted on this form is true and complete. This includes that I am the individual self-identified on this form and that I am a current staff or faculty member of Relay Graduate School of EducationSubmit