Change of Address Request Form If you are a returning student or a current student please contact Office of the Registrar
Last Name First Name Middle Name
Student Z-number
Date of Birth
Address Apt#
City State Zip
Home Phone Number:
Cell Phone Number:
E-mail Address
Submission of this document serves as your electronic signature. Submission of information online certifies that the information provided is complete and correct to the best of your knowledge. Any use of false names or identities is considered fraud.
comments or questions to: Undergraduate Admissions Office
