Student Address Update Form

1. Name and Contact Information *This question is required.

	Last Name
	First Name (Legal)
	Phone Number (include area code)
	CIA Email Address
	CIA ID Number (found on home page of MyCIA)

2. Please select which address you would like to update.

3. This is my Local/Campus address (i.e. where I reside when I am attending CIA): *This question is required.

	Street Address
	Apt/Suite/Room (e.g. Apt 203 or Suite 203 or Rm 203)
	City
	State
	Zip Code

3. This is my Permanent/Official Mailing address (i.e. where important mail should be delivered): *This question is required.

	Street Address
	Apt/Suite/Room (e.g. Apt 203 or Suite 203 or Rm 203)
	City
	State
	Zip Code

Verification