Address Change Request Form

         
  Last Name: First Name: Net ID or NDID (900#): Date:
 
         

CURRENT UNDERGRADUATE
CURRENT GRADUATE STUDENT
   
If you are not a current student, please visit the Alumni Association website for more information.

 
NEW LOCAL ADDRESS AND TELEPHONE (Only students who live off campus should use this form. Students who live on campus will have their addresses updated automatically by Campus Housing.)
 
Address:  
Address:  
City: State Zip  
Phone: - -          
Starting Date: Local addresses automatically stop at the end of the academic year
Cell Phone: - -

For emegency use only


 
NEW PERMANENT ADDRESS AND TELEPHONE (This is the student's home address of record, usually a parent, where official University correspondence will be directed.)
 
Address:  
Address:  
City: State Zip  
Phone: - -          
Starting Date:  
Cell Phone: - - For emergency use only

 
PRIVACY CODE: Local Address Permanent Address
  Local Phone Permanent Phone
 
The University of Notre Dame offers students the opportunity to withhold address and telephone information. By checking the boxes above, the student indicates a desire to remove this information from the online directories as well as the published campus phone directory (provided the request is made prior to publication). By selecting these options, the University will not disclose this information to outside sources.

Please print this form, sign and submit it to the Office of the Registrar, 300 Grace Hall, Notre Dame, IN 46556, or fax to: (574) 631-3865. If you have additional questions regarding this form, please contact the Office of the Registrar at (574) 631-7043.
 
 
Student Signature: __________________________________________________
Date:___________