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Change of Address

Student ID# *

First Name *

Last Name *

Address *

City *

State *

Zip Code *

Email *

Confirm Email *

Phone *

Phone Type *

Check all that apply *

Permanent Address (where I live when not in school)

Parent Address (only if different from permanent)

Local Address (where I live off-campus while attending school)

On-Campus PO Box

Leave this field blank