Change of Address Form
Registrar's Office (Records) - Middle Tennessee State University - Murfreesboro

M# (do not enter social security number)

Last Name
First Name
Middle Name

Permanent Mailing Address (where you reside when not attending school):

• Changing your permanent address will NOT update your residency status. To update your residency status, you must contact the MTSU Admissions office (undergraduate) or the College of Graduate Studies (graduate).
• Permanent address for international students must be country of origin, excluding permanent residents
  
  No. and Street Apt #
  City State Zip
  Phone (ac)
  

Mailing Billing Address (Check all types that apply to the following address):
No. and Street Apt #
City State Zip
Phone (ac)

Next of Kin Parent (Check all types that apply to the following address):
Last First Middle
Relationship
No. and Street Apt #
City State Zip
Phone (ac)

Emergency Contact: Mother Father Guardian Spouse
Last First Middle
No. and Street Apt #
City State Zip
Phone (ac)

Additional Telephone Numbers:
Phone (ac) Cell Business
Phone (ac) Cell Business

Additional E-Mail Addresses (Other than MTSU-assigned address.)

MTSU, a Tennessee Board of Regents university, is an equal opportunity, non-racially identifiable, educational institution that does not discriminate against individuals with disabilities.