Change Of Contact Information Form printable pdf download

37 S. Wabash Ave. Chicago, Illinois 60603 312.899-5100

CONTACT INFORMATION CHANGE FORM

(please fill out form completely and legibly)

Name

ID#

ADDRESS AND PHONE NUMBER CHANGE

If you would like ALL of your correspondence from the School to go to one address please write it below:

Phone Number

________________________________________________________________________________

Address ______________________________________________________________________________________

City __________________________________ State ______ Zip Code ________________Country __________

MAILING AND LOCAL ADDRESS AND PHONE NUMBER

Used for: Deficiency notices/Academic Standing, Pre-Registration/Graduation Information, Account/Financial Aid Information

and general mailings during breaks from semester.

Phone Number

________________________________________________________________________________

Address ______________________________________________________________________________________

City __________________________________ State ______ Zip Code ________________ Country

________

BILLING ADDRESS AND PHONE NUMBER

Used for: Tuition Bills and Billing Information

Phone Number

________________________________________________________________________________

Address ______________________________________________________________________________________

City __________________________________ State ______ Zip Code ________________ Country

________

HOME AND PERMANENT ADDRESS AND PHONE NUMBER

Used for: Grade Reports, also as a default address for all offices and general mailings during breaks from semester.

Phone Number

________________________________________________________________________________

Address ______________________________________________________________________________________

City __________________________________ State ______ Zip Code ________________ Country

________

EMERGENCY CONTACT INFORMATION

Name ______________________________________________

Relationship ____________________________

Phone Number

________________________________________________________________________________

Address ______________________________________________________________________________________

City __________________________________ State ______ Zip Code ________________ Country

________

Signature ____________________________________________________________________

9602-126

Change Of Contact Information Form