Current Address Change Form

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Your Information

Date submitted (mm/dd/yy):*

Last name:*

First name:*

Middle name:

ID Number*

Email address:*

OLD Mailing Address

Full Mailing address (OLD):*

NEW Mailing Address

Mailing Address (NEW):*

City:*

State:

Zip Code:*

County (for NYS residents only):

Please select all that apply to this address change:

For the Summer Only

Student Only Address and Phone

Student and Parent (custodial or guardian)

Non-Custodial Parent

Student Off Campus Address for Fall Semester

Student Off Campus Address for Spring semester

For Billing Purposes Only

Date that this change should be effective (mm/dd/yy):*

Comments: