Please complete all sections. USCIS regulations requires non- U.S. citizens to report a change of address, phone or email within 10 days of moving within the U.S. or its territories.

* 1. Student Information

* 2. Visa Type

* 3. Requesting Change in:

* 4. Previous Information

* 5. New Address

* 6. By typing my name below, I am verifying that the information above is the best to my knowledge.

* 7. Date

Date / Time
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