| CHANGE OF NAME OR ADDRESS FORM | |||||||||
| Please check all that apply | |||||||||
| I am a(n) | employee | student at the College. | |||||||
| CHANGE FROM: | |||||||||
| (Name) | |||||||||
| (Address) | |||||||||
| CHANGE TO: | |||||||||
| (Name) | |||||||||
| (Address) | |||||||||
| (New Phone#) | |||||||||
| (Social Security #) | |||||||||
| (Effective Date) | |||||||||
| FOR OFFICE USE ONLY | |||||||||
| CHANGED: | Payroll | ||||||||
| Human Resources | |||||||||
| Institutional Advancement File | |||||||||
| Registrar File | (if above employee is student) | ||||||||