CHANGE OF ADDRESS


CHANGE OF ADDRESS
"State Law gives you the right to request, receive, and correct information about yourself collected on this form."

SSN:

DATE:

STUDENT'S NAME:
		Last	First	MI

FORMER ADDRESS:

NEW ADDRESS:


STREET		APT #		STREET		APT #


CITY		STATE		ZIP		CITY		STATE		ZIP

COUNTY:

DATE MOVED:

NEW PHONE #:

Any tuition status revisions due to an address change, submitted after the official census date, will become effective the next regular term.

I understand that I must submit proof of physically residing at the new address if my former address was not in Bexar County. I certify that the above change and any other information submitted concerning my residence are true, complete and accurate.


STUDENTS	SIGNATURE

FOR OFFICE USE ONLY

Address changed:_____________

Initials: _______

Document Verified If Changed Involved Residency:_____________

Initials_______

The Alamo Community College District is an EOE. For any special accommodations or an alternate format,
contact the Title IV Coordinator at (210) 208-8051.