Off Campus Move Notification Form


NAME:    Last: ________________________________________   First: ________________________________

CURRENT MAILING ADDRESS:   Quad: _______________________________ Box #: ___________________


NEW MAILING ADDRESS:               Apt/Suite/Box #: _______________________________

Street: _______________________________________

City: _________________________________________

State: ______________________

 Zip + 4: _____________________


EFFECTIVE DATE: _________________________________________

SIGNATURE: _____________________________________________

Submit notification to the University Mail Facility located in the basement of the Business Administration Building, B4.