Change of Personal Information Form

Please complete this form to notify us of a change in your personal or contact information.

First Name

Middle Name

Last Name

Email Address

Student ID Number

Change or Update Address

Local Address

Local Address 2

Local City/Town

Local State/Province

Local ZIP/Postal Code

Local Country

Legal/Permanent Address

Legal/Permanent Address 2

Legal/Permanent City/Town

Legal/Permanent State/Province

Legal/Permanent ZIP/Postal Code

Legal/Permanent Country

Change or Update Phone Number

Cell Phone Number

Landline Phone Number

Parents Phone Number

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Copyright 2006-2022 Pratt Community College - 348 NE SR 61 - Pratt KS 67124
620-672-5641 | 1-800-794-3091 (KS Only) | Fax: 620-450-2285
After Hours Service, 620-672-9800 , M-F 5-9pm, Sat/Sun 10am-4pm
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Pratt Community College does not discriminate on the basis of race, color, national origin, sex, disability, age or veteran status in its programs and activities. The following person has been designated to handle inquiries regarding the non-discrimination policies: Director of Personnel, Pratt Community College, 348 NE SR 61, Pratt, Kansas 67124, 620.672.5641.

Change of Personal Information Form

Change or Update Address

Change or Update Phone Number

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