Free PennState Address Correction Form - PDF Form Download

PennState Address Correction Form
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Download and submit this form in your campus to update your Current Address.

PennState Address Correction Form


Text Version of this Form

———————– Page 1———————–

Address Correction Form

Return To:
Enrollment Services
112 Shields Building

University Park, PA 16802-1271
Fax: 814-863-1929

__________________________ PSU ID:
Student Name: ___________________________________ ______________________
Permanent Residence:

_______________________________________________________
Street 1:
_______________________________________________________
Street 2:
City/State/Zip: _______________________________________________________
Country: _______________________________________________________

Phone Number: _________-___________________

Local Address:
_______________________________________________________
Street 1:

_______________________________________________________
Street 2:
City/State/Zip: _______________________________________________________

Country: _______________________________________________________

Phone/Cell: _______-_____________________

Work Address:

Street 1: _______________________________________________________
_______________________________________________________
Street 2:
City/State/Zip: _______________________________________________________

Country: _______________________________________________________
Phone Number: _______-____________________

Revised: 8/13/07

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