Change Of Student Data Form
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1CLEAR FORM
Change of Student Data Form – University of Hawai'i
[ ] Hawai'i Comm College
Name (Last, First, Middle)_______________________________________
Admissions Office
200 W. Kawili St.
UH Number__ __ __ __ __ __ __ __ or UH Username _______________
Hilo, HI 96720
Check item(s) to be updated:
[ ] Honolulu Comm College
Records Office
[ ] Permanent address: (
NOTE
:
International students must list a non-US address.)
874 Dillingham Blvd.
Honolulu, HI 96817
_________________________________________________________
No./Street/Apt.#
City
State
Zip
[ ] Kapi'olani Comm College
Admissions Office-KISC
[ ] Mailing address:
4303 Diamond Head Rd.
Honolulu, HI 96816
_________________________________________________________
No./Street/Apt.#
City
State
Zip
[ ] Kaua'i Comm College
Admissions Office
SELECT
3-1901 Kaumualii Hwy.
[ ] Phone Number: (
)______-________
Type: ______ (
e.g., Cell)
Lihue, HI 96766
[ ] Leeward Comm College
Are you an international student? [ ] YES
[ ] NO
Admissions Office
If you are an international student, you are also required to report your address changes
96-045 Ala 'Ike
to the office responsible for serving international students at your home campus (e.g.,
Pearl City, HI 96782
ISS at UH-Mānoa, Honda Center at Kapi'olani Community College, etc.).
[ ] UH, Maui College
Admissions Office
Signature______________________________ Date_________________
310 Ka'ahumanu Ave.
Kahului, HI 96732
Please be sure to indicate your home campus by checking the appropriate
box in the column to the left. After you have completed and signed this
[ ] Windward Comm College
form, you may send it to the Admissions or Records Office at your home
Admissions Office
campus as indicated, or take it to the Admissions and Records Office at
45-720 Kea'ahala Rd.
any campus.
Kaneohe, HI 96744
[ ] UH Hilo
Records Office
200 W. Kawili St.
************************************************************
Hilo, HI 96720
For office use only
[ ] UH Mānoa
Office of the Registrar
Entered by ______________________
Date ______________________
2600 Campus Rd., Rm 10
Honolulu, HI 96822
Institution________
[ ] UH West O'ahu
Student Services Office
91-1001 Farrington Hwy
Kapolei, HI 96707
03/13
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