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And Immigration Services Bcis

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					CHANGE LOCAL ADDRESS

The Bureau of Citizenship and Immigration Services (BCIS) requires F and J visa holders to report their new local
address within 10 days of any change. You must submit this form when you change your address so that we
can change your local address in SEVIS. This form is always available in C101.

LOCAL INFORMATION Date ________________

Print your last name as it is on your I-20: __________________________________First name: ________________
CESL id#_________ Tucson phone number: ______________ Email ____________________________________

Your address in Tucson: ________________________________________________________________ 857 __ __
                        (This must be a street address)

What is your visa type? ____F-1/F-2 ___ J-1/J-2 ___ R ___ US citizen ____ US Permanent Resident ______ other

EMERGENCY CONTACT

Name__________________________________________ Email _______________________ Telephone ________
We will call 911 for immediate treatment and notify the emergency contact as soon as possible.




CHANGE LOCAL ADDRESS

The Bureau of Citizenship and Immigration Services (BCIS) requires F and J visa holders to report their new local
address within 10 days of any change. You must submit this form when you change your address so that we
can change your local address in SEVIS. This form is always available in C101.

LOCAL INFORMATION Date ________________

Print your last name as it is on your I-20: __________________________________First name: ________________
CESL id#_________ Tucson phone number: ______________ Email ____________________________________

Your address in Tucson: ________________________________________________________________ 857 __ __
                        (This must be a street address)

What is your visa type? ____F-1/F-2 ___ J-1/J-2 ___ R ___ US citizen ____ US Permanent Resident ______ other

EMERGENCY CONTACT

Name__________________________________________ Email _______________________ Telephone ________
We will call 911 for immediate treatment and notify the emergency contact as soon as possible.
                                                                                                   Updated 9/26/2006

				
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