CHANGE OF ADDRESS
Please complete and return to the Registrar’s Office
AS-Registrar@Asnuntuck.edu
Student ID #: ________________________
Last Name: _________________________ First Name: ________________ Middle/Maiden: _______________
FORMER ADDRESS:
Street Address: ______________________________________________________________________
City: _______________________________ State: ___________ Zip: ____________
NEW ADDRESS:
Street Address: ______________________________________________________________________
City: _______________________________ State: ___________ Zip: ____________
Phone: ______________________ ______________________ ______________________
(Home) (Cell) (Work)
Student’s Signature: ____________________________________ Date:___________________
Registrar’s Office Use Only: Banner (SPAIDEN) Updated: ___________________
Notice of Non-discrimination: Asnuntuck Community College does not discriminate on the basis of race, color, religious creed, age, sex, national origin,
marital status, ancestry, present or past history of mental disorder, learning disability or physical disability, sexual orientation, gender identity and
expression or genetic information in its programs and activities. In addition, the College does not discriminate in employment on the basis of veteran
status or criminal record. The following individuals have been designated to handle inquiries regarding the non-discrimination policies: Yhara Zelinka,
Title IX Coordinator, yzelinka@asnuntuck.edu (860) 253-3092 and Deborah Kosior, 504/ADA Coordinator, AS-DisabilityServices@asnuntuck.edu (860)
253-3005, Asnuntuck Community College, 170 Elm Street, Enfield, CT 06082.
Políticas Antidiscriminatorias: Asnuntuck Community College no discrimina por razones de raza, color, creencias religiosas, edad, género, nacionalidad,
estado civil, ascendencia, historia presente o pasada de discapacidad mental o física, problemas de aprendizaje, orientación sexual, Identidad y
expresión de género, o información genética, en sus programas o actividades. Adicionalmente Asnuntuck no discrimina individuos por razones
pertinentes a la categoría de veteranos o historia criminal. Las siguientes personas han sido designadas para resolver cualquier inquietud pertinente a
las políticas antidiscriminatorias: Yhara Zelinka, Title IX Coordinator, yzelinka@asnuntuck.edu (860) 253-3092 and Deborah Kosior, 504/ADA
Coordinator, AS-DisabilityServices@asnuntuck.edu (860) 253-3005, Asnuntuck Community College, 170 Elm Street, Enfield, CT 06082.
Updated April 2020
