Residential Student Change of Address Form


NAME:       Last: ___________________________________________

                 First: _______________________________________    MI: ________

OLD MAILING ADDRESS:        Quad: ________________________________

Box #: _______________________


NEW MAILING ADDRESS:        Quad: _________________________________

Box #: ____________________________


CAMPUS PHONE NUMBER: ____________________________________

EFFECTIVE DATE: _________________________________________

SIGNATURE: ______________________________________________

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