Please Print Clearly
Full Name ______________________________________________Date _________________
ID # ______________________ Major ___________________Degree ___________________
- - - - - - - - - - - - - - - - - - - CHANGE OF ADDRESS INFORMATION - - - - - - - - - - - - - - - - - - - - - -
Fall Semester
Local address or Local address or
CPO Box (if applicable) _________________
____________________________________
____________________________________
____________________________________
Daytime Phone (_______ )_____________
E-mail address: _____________________
Spring Semester
Local address or Local address or
CPO Box (if applicable) _________________
____________________________________
____________________________________
____________________________________
Daytime Phone (_______ )_____________
E-mail address: _____________________
Signature:___________________________________________________________________
RETURN FORM TO THE REGISTRAR’S OFFICE
GC 2-1/2 E
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