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OFFICE OF THE REGISTRAR | CHANGE OF CONTACT INFORMATION

Change your Contact Information:

Your information will be updated once this form is submitted. Personal phone numbers and email addresses must belong to you. If you wish to provide contact information for a parent or another individual, it must be submitted through the FERPA Release Form. Please note that no communication containing private or secure educational records will be sent to the email address listed below.

Student Name:

Today's Date: 

Personal Email Address:

Mobile Number: 

Student Acknowledgment and Authorization:

By submitting this Personal Information Change Form, I acknowledge and agree to the following:

1. I am the individual requesting these changes to my student record.
2. The information provided is accurate and reflects my personal details as required by the institution.
3. I understand that this request will result in updates to my official student records, and it is my responsibility to ensure that all provided documentation, if required, is valid and up to date.
4. I acknowledge that falsification of information may result in disciplinary action in accordance with institutional policies.
5. I understand that changes to my personal information may take time to process and that I will be notified if additional verification is needed.

Please Check the box to indicate agreement

APPID:

StudentID:

Student Email Address: