Change of address form

This information is needed to positively identify you:

Last name:	First name:
Middle Name:	Maiden/Other:

Date of Birth:

Last Attended GC:

Social Security Number/Student ID Number: - -

E-mail address:

You MUST select ONE address to which this change applies:

	1. Mailing: The primary address used for mailings from the Goshen College.
	2. Local: Use this address, in addition to your mailing address, if your mailing address is a PO Box or not your local residence address.
	3. Temporary: Date sensitive address used to over-ride your mailing address when you are away – between semesters, over the summer, or while on SST. Effective dates from : to:
	4. Parent: Used to send press releases which mention you. Submit an address for EACH parent if they do not live together.

Enter New Address

Please allow 2 - 3 working days for changes to take effect.