CHANGE OF ADDRESS/PHONE NUMBER FORM
Name _______________________________________________ UH # or Username ____________________
(LAST, FIRST, MIDDLE OR MIDDLE INITIAL)
I am requesting the following checked item(s) to be updated: (If your mailing address is different from your
physical location address, please provide your physical location address.)
NEW PERMANENT MAILING ADDRESS
________________________________________________________________________________________
STREET NUMBER CITY/PROVINCE STATE/COUNTRY ZIP/POSTAL CODE
NEW CURRENT MAILING ADDRESS
_______________________________________________________________________________________
_
STREET NUMBER CITY/PROVINCE STATE/COUNTRY ZIP/POSTAL CODE
NEW PHYSICAL LOCATION ADDRESS
_______________________________________________________________________________________
STREET NUMBER CITY/PROVINCE STATE/COUNTRY ZIP/POSTAL CODE
NEW PHONE NUMBER: ( ) ____________________________
Cell Home W
ork
NEW PHON
E NUMBER: ( ) ____________________________
Cell Home W
ork
Are yo
u an international student?
YES
NO
Note: Students on F-1 and J-1 visas are required to notify the International Student Services office at your home campus within 10 days whenever
your address changes.
Please indicate your home campus by checking the appropriate box. After signing below, submit the completed form
to your home campus.
Home Campus
Contact Information
University of Hawai'i at Mānoa
Office of the Registrar, QLC, 2600 Campus Road, Room 001
Honolulu, HI 96822
University of Hawai'i at Hilo Office of the Registrar, 200 W. Kāwili St., Hilo, HI 96720-4091
University of Hawai'i West O'ahu
Secure File upload: Select Records Department
http://westoahu.hawaii.edu/it/securefiletransfer
Hawai'i Community College
Secure File upload: https://www.hawaii.edu/filedrop
Add recipient: hawccar@hawaii.edu
Honolulu Community College
Admissions Office, 874 Dillingham Blvd., Building 6, 1st Floor
Honolulu, HI 96817
Kapi‘olani Community College
Secure File upload: https://www.hawaii.edu/filedrop
Add recipient: kapinfo@hawaii.edu
808-734-9896
Kaua‘i Community College
Admissions & Records Office, One Stop Center 101 3-1901
Kaumualii Highway, Lihue, HI 96766
Leeward Community College
Admissions & Records Office, 96-045 Ala Ike, Pearl City HI 96782
OR Secure File upload: https://www.hawaii.edu/filedrop
Add recipient: lccar@hawaii.edu
UH Maui College 310 W. Ka‘ahumanu Avenue Kahului, HI 96732-1617
808-984-3872
Windward Community College
Admissions & Records Office, Hale Alakai, Room 112
45-720 Kea‘ahala Rd. Kāne‘ohe, Hawai‘i 96744
Call 808-235-7432
before faxing
D
ate:
Student’s Signature:
Revised as of 11/02/2020
Office use only: Input by: Date:
Directions: Printing clearly, use this form to change or update your address/phone number on record.
I certify that I am the above listed person and I authorize the Records office to reflect the changes requested above.
click to sign
signature
click to edit
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