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Student Address Change Form

College of Pharmacy Pharm.D. students must change their addresses with BOTH the College of Pharmacy and Oregon State University. Complete the form below to change your address or other contact information with the College of Pharmacy.

If you wish your student information to be restricted:

This will exclude your name and address from all external, noneducational requests for student mailing lists. These mailing lists are made available to student organizations or faculty & staff to allow them to make information available to you. This restriction does not pertain to official College of Pharmacy needs or to other educational uses. To limit this information from the whole campus, you still must fill out the registrar's form. This restriction is NOT the same as a complete restriction on student information.

Effective Date:

Your Name:

Year in the Pharm.D. Program: P1 P2 P3 P4

E-Mail Address:

Current Address -- where you are living now:
Current Telephone:
Permanent Address -- someone who will know how to reach you; for example, your parents:
Permanent Telephone:

 

Thank you for your help in keeping your records up-to-date.