ADDRESS CHANGE FORM
Please fill out a separate form for each address changed.
Return completed form to the Registrar’s Office, Rusk Bldg. Rm. 202
Fax: 936-468-7638 or registrar@sfasu.edu
Printed Name:
LAST
SFA Box # (if applicable)
FIRST
ID#_____________________
MIDDLE
(Please mark one) Box Closure is for:
#1 ADDRESS
Individual
Family
Mark only ONE option that applies to this address:
Mailing (not SFA Box)
Permanent
Emergency Contact
Diploma
Permanently Close
SFA PO Box*
Start Date
Street/Box/Apartment Number /Email Address
Town/City
(Area Code)
State
Zip Code
Phone Number
____
*Student Signature:
If updating Emergency Contact, list name here:
______________________________
*Must be notarized.
*I acknowledge that I no longer live in University housing, and am relinquishing my SFA PO Box for
reassignment.
*If you are currently employed or have been employed by SFASU, you must also
contact the payroll office to change your address.
*If
you are updating your address for Refund purposes, you must also log on to Higher
One and update your address there.
State of Texas
County of _______________
Before me, a notary public, on this day personally appeared _____________________, known to me to
be the person whose name is subscribed to the foregoing document and, being by me first duly sworn,
declared that the statements therein contained are true and correct.
Notary Seal:
Form updated 4/2013
________________________
Notary Public’s Signature