This is what the home site says:
“Can I change my name at the time of divorce?
North Carolina law allows a spouse, in conjunction with a divorce, to take a name other than the current spouse’s last name. You would petition for the name change when you file your divorce complaint or when you file your answer to your husband’s complaint. In your complaint for divorce or your answer, you may petition the court to change your name to either your maiden name, the surname of a prior deceased husband or the surname of a prior living husband if you have children who have that husband’s surname. The court will issue an order at the time of the divorce granting your request for a name change. There is no additional cost for this name change if it is done at the same time as the divorce. Should you decide after the divorce that you want such a name change, you just present your divorce judgment to the clerk of court. For a nominal fee, you will be allowed to have one of the name changes specified above: maiden name, name of a prior deceased husband, name of a prior husband with whom you had a child with that same last name.”
As far as how to word it, if you are doing the paperwork yourself, I would think that it would just state that you would like to petition the court to have your name changed at the time of the divorce.