Address, Phone, and Email Update Form — The Nevada Office of Western Interstate Commission for Higher Education (WICHE)

Has your address, phone number or email changed? Please keep us informed by completing the form below:

Name(Required)

First Last

Do you have a new permanent address?

Yes

Do you have a new primary phone number?

Yes

Do you have a new primary email address?

Yes

Field of Study(Required)

New Permanent Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Previous Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

New Primary Phone Number(Required)

Previous Phone Number(Required)

New Primary Email(Required)

Previous Email(Required)

Additional Comments

Please add any additional details related to your change in contact details.

Please attach any supporting documents

Example: Documents supporting a name change.

Signature(Required)

Hidden

Signature Date