Fillable WINTHROP UNIVERSITY ADDRESS/EMAIL UPDATE FORM

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WINTHROP UNIVERSITY ADDRESS/EMAIL UPDATE FORM

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The WINTHROP UNIVERSITY ADDRESS/EMAIL UPDATE FORM form is 1 page long and contains:

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File type: PDF

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WINTHROP UNIVERSITY
Offi ce of Records and Registration
ADDRESS/EMAIL UPDATE FORM
Student Name _____________________________________
Student ID# _____________________________________
Local Address (Where you live while attending Winthrop. If you live on campus, you do not need a local address.)
Permanent Address (Bills will be sent here unless otherwise noted.)
Next of Kin Address (Your closest relative.)
Are you a permanent employee of Winthrop? Yes No If yes, please visit the Human Resources Offi ce.
Check all that apply.
Local Permanent Next of Kin
____________ ____________________________________________________________
Apt # Street
____________________________________________ ______________________________
City State Zip Phone#
Check all that apply.
Local Permanent Next of Kin
____________ ____________________________________________________________
Apt # Street
____________________________________________ ______________________________
City State Zip Phone#
Check all that apply.
Local Permanent Next of Kin
____________ ____________________________________________________________
Apt # Street
____________________________________________ ______________________________
City State Zip Phone#
Emergency Contact
___________________________________ ____________________________________
Name Relationship
____________ ____________________________________________________________
Apt # Street
____________________________________________ ______________________________
City State Zip Phone#
Email (Winthrop email addresses cannot be changed.)
________________________________ ____________________________________
From To
_____________________________________ __________________________________________
Signature Date
Offi ce Use Only
Date_________
By __________
2/15
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WINTHROP UNIVERSITY ADDRESSEMAIL UPDATE FORM

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Completed 7 March 2020

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