IIE_Template - Change of Address - CollegeBoard
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Transcript of IIE_Template - Change of Address - CollegeBoard
CHANGE OF ADDRESS/PERSONAL CONTACT INFORMATION
U.S. federal visa regulations require all Exchange Visitors to provide their visa sponsors with a current local U.S.
address and up-to-date personal contact information at all times. Accordingly, it is imperative that you inform the
Institute of International Education (IIE) of any subsequent change to your address or contact information. You
must report any change within ten (10) days of said change. You can report this change by completing and emailing
(PDF) this form to [email protected].
Important Notes:
Post Office Box (“P.O. Box”) or university campus mail box addresses are not acceptable.
Please provide a complete street address (Example: 123 House Street, Apt. 1, Any Town, Any State,
12345). If applicable, give the name of the residence hall and room number of where you are physically
residing.
If your mailing address is different than your physical residence address, then write it in the body of the
email you send to submit this form.
Failure to keep IIE informed of your current address and contact information can result in you being
considered out of status, and possibility result in the termination of your sponsorship.
Personal Address and Contact Information: Please complete all fields below. Please print clearly.
IIE ID # (Found on your Terms of Appointment) ____________________
FIRST NAME: _______________________________ LAST NAME: ________________________________
HOME COUNTRY: ____________________________
NAME OF HOST ORGANIZATION: ____________________________________________________________
NUMBER AND STREET NAME: ______________________________________________________________
BUILDING NAME AND ROOM # (if applicable): __________________________________________________
CITY: _______________________________ STATE: ________________ ZIP CODE (5 digits): _____________
E-MAIL ADDRESS: ____________________________ TELEPHONE NUMBER: _______________________
EFFECTIVE DATE OF CHANGE: _________________
________________________________________ _____________________
Signature of Exchange Visitor Date