(reg-00001a) Change of Contact Form

Change of Contact Information

If your student is living in your home, you may submit this form:

If any of your contact information (address, phone number or email address) has changed
If you have MOVED, you must also provide proof of residency by attaching the appropriate documentation when submitting this form. Acceptable documentation includes:

Current water, gas or electric bill (within the last 30 days), OR
Current lease or rental agreement, OR
Current Mortgage statement

If your student is living with someone else outside of your home, DO NOT USE THIS FORM and follow the instructions at the bottom of this page.

Student's Name *

Student ID

Date

School *

Submitter's Email *

Does this replace a current email address

If yes, which one? (Please check box and provide old email address). If yes, which one? (Please check box and provide old email address).

Student's Address (Street, City, State & Zip)

Phone Number

Does this replace a current phone number?

If yes, which one? (Please check box and provide old phone number). If yes, which one? (Please check box and provide old phone number).

Submitter Signature *

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Note: If your student is living with someone else, DO NOT USE THE FORM ABOVE. The following documentation must be completed by the resident of the home where your student is living. Notarize and deliver the completed form to the registrar at your student's school in person or through the mail. (It cannot be emailed or sent electronically).

Completed, notarized Address Verification Form (click here to download).
Current utility bill (within the last 30 days) for the resident with whom the student is living
Proof the parent of the student is receiving mail at the address where the student is living