University of Hartford

CHANGE OF PERSONAL DATA

 

Please print clearly.

 

Current Information

 

Identification number      ___  ___  ___  ___  ___  ___  ___  ___    Date ________________

 

Last name __________________________  First name _________________  MI ______

 

Check the category below that has changed and enter the new information:

 

New Information

 

(  )  PERMANENT address _________________________________________________

      (this is your HOME address) _____________________________________________

 

(  )  MAILING** address ___________________________________________________

      (see below)                 ___________________________________________________

 

(  )  LOCAL address         ___________________________________________________

                                          ___________________________________________________

 

(  )  UofH box no.   ________________________________________________________

 

(  )  HOME phone   _______________________________________________________

 

(  )  LOCAL phone _______________________________________________________

 

(  )  WORK phone  _______________________________________________________

 

(  )  NAME              _______________________________________________________

 

-  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -

 

** Note:  This is the address to which you would like all University correspondence (grades, schedules, etc.) mailed.  It will not replace any other address, but it may be the same as another category.

Mailings such as grades and student schedules are automatically sent to your Permanent (Home) address.  If you want these materials sent to your Permanent address, there is no need to supply us with a Mailing address.  When we send mailings off campus, we search first for the Mailing address; if none is found, it defaults to your Permanent address.

International students who do not want their mail sent out of the country can use their box numbers on campus, Local or Mailing address as their address for all correspondence.  We will not change your Permanent address to a Mailing address.

 

change of data form.doc rev. 6/1/05