Date (required)

Legal Name: Last, First, Middle, Maiden/Birth Name (required)

Student Digitial Signature: Sign with First and Last Name (required)

Note: If this is a new name, you must complete an official Name Change form and provide Documentation of the change.

I want this address to be used for (check all that apply):
Mailing address, current addressParent(s) addressPermanent address, parent/family/hometown address

New Address (required)

Phone (required)

Effective Date (required)

I would also like to update my non-OSSM email: (required)
I am a Current StudentI am an Alumnus

Your Current E-mail Address: (required)

New non-OSSM E-mail:

I would also like to update my the address(es) for my parent(s):

Parent Name:

Address

Phone

Parent E-mail: