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Change of Current Mailing Address / Email Address

Note: Use Tab key or mouse to navigate form - Do NOT press Enter until ready to submit form.


Student Name:
First
Middle
Last (Family)

Oregon State Unviversity ID Number (9 digits):
(If you do not have an OSU ID Number yet, leave above box empty.)

Email:

Date of Birth: Month   Day   Year

Current Mailing Address:




 
City                                                            State         Zip

Phone Number:

(By clicking the Submit button, I certify that all information on this form has been completed to the best of my knowledge and this action will represent my signature.)