Change of Address/Data Correction Form

Change of Address/Data Correction Form
American Association of Collegiate Registrars and Admissions Officers
It is our commitment to provide accurate and up-to-date membership information, but we need your help. Please
update your membership information whenever it changes. Use this form to make changes or corrections to your
data, to delete someone from your membership roster, or to replace a member.
Membership Information
Name of Institution: ___________________________________________________________________________________
Address: _____________________________________________________________________________________________
City: _________________________________ State: _______ Zip or Postal Code: _________ Country: _______________
Web site: _____________________________________________________________________________________________
Main Contact Person: __________________________________________________________________________________
Update Information For:_________________________________________________________________________________
Replace: ___________________________________________________________________ (name of member to be deleted) with
_________________________________________________________ (name of person to be added—please fill out the entire form)
Update Membership Roster (Submit one for each person. Make additional copies as necessary.)
Name: _____________________________________________ Title: ____________________________________________
Address: _____________________________________________________________________________________________
City: _________________________________ State: _______ Zip or Postal Code: _________ Country: _______________
Phone: _____________________
Fax: ____________________
E-mail: _______________________________________
In what areas do you work? (check all that apply)
Gender: ❒ M
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Race: (optional)
Age Group:
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Academic Advising
Admissions
Computer/Information Services
Enrollment Management Services
Financial Aid
International Admissions
Institutional Research
Records and Registration
Student Affairs
Transfer and Articulation
Other Position: ______________________________
Submit Your Correction
SOURCE CODE:
___________
FOR OFFICE USE ONLY:
African-American/Black, non-Hispanic
American Indian or Alaska Native
Asian or Pacific Islander
Hispanic/Latino/Latina
White, non-Hispanic
Prefer not to specify
Other: __________________________
25 and under
26 – 35
36 – 45
46 – 55
56 – 65
66 – 75
76+
Questions?
Mail to: AACRAO—Membership, One Dupont Circle, NW,
Suite 520, Washington, D.C. 20036 OR
Fax to: (202) 872-8857
❒ F
Call: (202) 293-9161 OR
E-mail: [email protected]
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DATE:
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INPUT:
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