OFFICE OF THE REGISTRAR
CHANGE OF ADDRESS/PHONE
(Current physical address to which campus information may be sent)
Fax 304-473-8531
Email: registrar@wvwc.edu
ID # ____________________________ DATE: _____________________________
LAST NAME: __________________________ FIRST NAME: ____________________ M. _________
EMAIL: ________________________________________
NEW ADDRESS/PHONE
STREET: ____________________________________________________________________
CITY, STATE, ZIP:____________________________________________________________
HOME PHONE: _____ ______________________
CELL PHONE: _____ ______________________
STUDENT SIGNATURE: ______________________________________________________
EFFECTIVE DATE OF NEW ADDRESS: ___________________________________
OFFICE USE ONLY
______ Reg Staff Initials ___________________ Date processed
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