Registrars Office
Address Change Form
Please complete this form, sign, date and return to Registrar’s Office, SSC L157 or mail to Manchester Community College, Registrar’s Office, Great Path, MS #13, P.O. Box 1046,
Manchester, CT 06045-1046 or fax to 860-512-3221.
STUDENT INFORMATION
First Name MI Last Name
Banner ID Number
Please indicate new mailing address.
New Mailing Address Apt. #
City State Zip
Phone Number Email
SIGNATURE
Student Signature Date
November 2019/PR
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