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Get Change Of Permanent Address And Personal Information

On Date: Effective Date for Permanent Address: Street Line 1: Street Line 2: Street Line 3: City: Zip Code: Change in Marital Status: State: OH Country US Married Single Phone Number: Change in Title: Mrs. Ms. Miss Mr. Change of Name: Student Signature: Date: * Please complete this form and press button above to print it out. Then sign it and deliver it to the Registrar's Office. * Your PARENT Address information must be changed via your Luminis Account. Rev. 03/02/2010.

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