OFFICEOFADMISSIONS
Revised 10/2018 Address: P.O. Box 270 Winnebago, Nebraska 68071 • Phone: 402.878.2380 •Website: www.littlepriest.edu
Change of Student Information
Student Name: _______________________________ ID Number: ____________
Previous Address: ___________________________________________
City, State, Zip: _____________________________________________
Email Address: ______________________________________________
Please make the following change(s) on my records:
Date of change: _________________________________
Change of information:
______________________________________________
Street, Box #, RR
___________________________________________________
City State Zip
Phone Number: __________________________________
Cell Phone Number: ___________________________________
I hereby certify the above statements are true.
________________________________________
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