back text image   small graphic of a printer [Text Only Version]

Student Address Update

You are responsible for maintaining current address with Southeast Kentucky Community & Technical College complete this form if your address has changed.


NAME: _____________________________________________________

SOCIAL SECURITY or STUDENT ID NUMBER____________________
  Old Address New Address
Address:_______________________________
City:___________________________________
St:_______________________Zip:__________		 Address:______________________________
City:_________________________________
St:______________________Zip:__________
Phone: (_____)________-__________________ Phone: (_____)________- _________________

Signature: ____________________________   Date:   ________________________
INSTRUCTIONS:
(1) Print a copy of this form
(2) Complete all requested information
(3) Sign form
(4) Return to:
Registrar's Office
Rm 111, Newman Hall
Southeast Kentucky Community & Technical College
700 College Road
Cumberland, KY 40823