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11111111111111111111111111111111111111111111111111111111111111111111111000000111111111111111111111111111111111111111111111111111 11111111111111111111111111111111111111111111111111111111111111111111111000000111111111111111111111111111111111111111111111111111 1111111111111111111111111111111111111111111111111111111111111111111111100000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000400000007010100030000000000}} \par \par }\pard\plain \s1\ql \li0\ri0\keepn\widctlpar\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\b\f29\fs20\cf6 CHANGE OF STUDENT DATA: \par }\pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\b\i\fs22 \par CHANGES WILL }{\b\i\fs22\ul\cf6 ONLY}{\b\i\fs22 BE PROCESSED FOR STUDENTS CURRRENTLY ENROLLED \par }{ \par }{\i Please}{\b\i }{\b\i\ul\cf6 print}{\b\i }{\i information }{\b\i as it now appears on our records. \par }{\lang1024\langfe1024\noproof {\shp{\*\shpinst\shpleft3420\shptop120\shpright6732\shpbottom552\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz11\shplid1027 {\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn lTxid}{\sv 131072}}{\sp{\sn fFitShapeToText}{\sv 0}}{\sp{\sn fillColor}{\sv 14540253}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\shptxt \pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs22 DOB\-______________________ \par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8203\dptxbx\dptxlrtb{\dptxbxtext\pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs22 DOB\-______________________ \par }}\dpx3420\dpy120\dpxsize3312\dpysize432\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr221\dpfillbgcg221\dpfillbgcb221\dpfillpat1\dplinehollow}}} {\shp{\*\shpinst\shpleft-36\shptop120\shpright3276\shpbottom552\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz10\shplid1028{\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn lTxid}{\sv 196608}}{\sp{\sn fFitShapeToText}{\sv 0}}{\sp{\sn fillColor}{\sv 14540253}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\shptxt \pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs22 SS# ______________________ \par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8202\dptxbx\dptxlrtb{\dptxbxtext\pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs22 SS# ______________________ \par }}\dpx-36\dpy120\dpxsize3312\dpysize432\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr221\dpfillbgcg221\dpfillbgcb221\dpfillpat1\dplinehollow}}} {\shp{\*\shpinst\shpleft0\shptop120\shpright3312\shpbottom552\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr2\shpwrk0\shpfblwtxt0\shpz9\shplid1029{\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn lTxid}{\sv 262144}}{\sp{\sn hspNext}{\sv 1029}}{\sp{\sn fFitShapeToText}{\sv 0}}{\sp{\sn fillColor}{\sv 14540253}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillShape}{\sv 1}} {\sp{\sn fLine}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\shptxt \pard\plain \s3\ql \li0\ri0\keepn\widctlpar\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\itap0 \i\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\b GCC ID #}{___________________}{\i0 \par }\pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 { \par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8201\dptxbx\dptxlrtb{\dptxbxtext\pard\plain \s3\ql \li0\ri0\keepn\widctlpar\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\itap0 \i\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\b GCC ID #}{___________________}{\i0 \par }\pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 { \par }}\dpx0\dpy120\dpxsize3312\dpysize432\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr221\dpfillbgcg221\dpfillbgcb221\dpfillpat1\dplinehollow}}}}{\i\fs22 \par }{\b\i \par }{\lang1024\langfe1024\noproof {\shp{\*\shpinst\shpleft-3492\shptop329\shpright6732\shpbottom1076\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr2\shpwrk0\shpfblwtxt0\shpz8\shplid1030 {\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn lTxid}{\sv 327680}}{\sp{\sn fillColor}{\sv 12632256}}{\sp{\sn fFilled}{\sv 1}} {\sp{\sn fLine}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\shptxt \pard\plain \ql \li0\ri0\sb120\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\i\fs22 __________________________________________________________________________________ \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b\i Student name (Last, First, Middle}{\b\i\fs22 )}{ \par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8200\dptxbx\dptxlrtb{\dptxbxtext\pard\plain \ql \li0\ri0\sb120\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\i\fs22 __________________________________________________________________________________ \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b\i Student name (Last, First, Middle}{\b\i\fs22 )}{ \par }}\dpx-3492\dpy329\dpxsize10224\dpysize747\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr192\dpfillbgcg192\dpfillbgcb192\dpfillpat1\dplinehollow}}}}{\b\i \par \par }{\i\fs22 Please read carefully and }{\b\i\fs22\ul print appropriate changes only. \par }{\lang1024\langfe1024\noproof {\shp{\*\shpinst\shpleft-432\shptop211\shpright-144\shpbottom499\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz1\shplid1031 {\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn pictureDblCrMod}{\sv 271778803}}{\sp{\sn lineColor}{\sv 255}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn shadowType}{\sv 5}}{\sp{\sn shadowColor}{\sv 278462961}} {\sp{\sn shadowHighlight}{\sv 275121139}}{\sp{\sn shadowOffsetX}{\sv 12700}}{\sp{\sn shadowOffsetY}{\sv 12700}}{\sp{\sn fShadow}{\sv 1}}{\sp{\sn f3D}{\sv 0}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8193\dprect\dpx-432\dpy211\dpxsize288\dpysize288 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinehollow}}}}{\b\i \par CHANGE OF NAME}{\b\i\fs24 }{(Attach copy of Driver\rquote s License, marriage license, divorce decree, etc.) \par }{\lang1024\langfe1024\noproof {\shp{\*\shpinst\shpleft0\shptop183\shpright10080\shpbottom1623\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr2\shpwrk0\shpfblwtxt0\shpz6\shplid1032 {\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn lTxid}{\sv 393216}}{\sp{\sn fillColor}{\sv 14540253}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillShape}{\sv 1}}{\sp{\sn lineColor}{\sv 9868950}}{\sp{\sn lineWidth}{\sv 38100}} {\sp{\sn lineStyle}{\sv 1}}{\sp{\sn fLine}{\sv 1}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\shptxt \pard\plain \ql \li0\ri0\sb120\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {(}{\b New}{)LAST _________________________________________________________ \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 { \par FIRST _________________________________________________________ \par \par MIDDLE________________________________________________________ \par \par \par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8198\dptxbx\dptxlrtb{\dptxbxtext\pard\plain \ql \li0\ri0\sb120\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {(}{\b New}{ )LAST _________________________________________________________ \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 { \par FIRST _________________________________________________________ \par \par MIDDLE________________________________________________________ \par \par \par 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fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8194\dprect\dpx-432\dpy58\dpxsize288\dpysize288 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinehollow}}} {\shp{\*\shpinst\shpleft0\shptop346\shpright10080\shpbottom2970\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr2\shpwrk0\shpfblwtxt0\shpz7\shplid1034{\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn lTxid}{\sv 458752}}{\sp{\sn hspNext}{\sv 1034}}{\sp{\sn fillColor}{\sv 14540253}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn lineColor}{\sv 9868950}}{\sp{\sn lineWidth}{\sv 38100}} {\sp{\sn lineStyle}{\sv 1}}{\sp{\sn fLine}{\sv 1}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\shptxt \pard\plain \ql \li0\ri0\sb120\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs22 ______________________________________________________________________________________ \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {Number\tab Street\tab \tab \tab \tab Apt#\tab \tab \tab City\tab \tab State\tab \tab Zip \par }{\b\i \par }\pard \ql \li0\ri0\sl360\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b\i MAILING ADDRESS}{: \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\fs22 _______________________________________________________________________________________ \par }{Number\tab Street\tab \tab \tab \tab Apt#\tab \tab \tab City\tab \tab State\tab \tab Zip \par \par E-Mail Address____________________________________________ (__________) __________________________ \par \tab \tab \tab \tab \tab \tab \tab Area Code Phone Number \par \par \par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8199\dptxbx\dptxlrtb{\dptxbxtext\pard\plain \ql \li0\ri0\sb120\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs22 ______________________________________________________________________________________ \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {Number\tab Street\tab \tab \tab \tab Apt#\tab \tab \tab City\tab \tab State\tab \tab Zip \par }{\b\i \par }\pard \ql \li0\ri0\sl360\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b\i MAILING ADDRESS}{: \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\fs22 _______________________________________________________________________________________ \par }{Number\tab Street\tab \tab \tab \tab Apt#\tab \tab \tab City\tab \tab State\tab \tab Zip \par \par E-Mail Address____________________________________________ (__________) __________________________ \par \tab \tab \tab \tab \tab \tab \tab Area Code Phone Number \par \par \par }}\dpx0\dpy346\dpxsize10080\dpysize2624\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr221\dpfillbgcg221\dpfillbgcb221\dpfillpat1\dplinew60\dplinecor150\dplinecog150\dplinecob150}}}}{CHANGE OF ADDRESS/PHONE NUMBER }{\highlight7 NO P. O. 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\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinehollow}}}}{\b\i CHANGE OF SOCIAL SECURITY NUMBER \par }{ \tab }{\b\fs22 Attach copy of social security card \par }{\fs22 \par \par }\pard\plain \s5\ql \li0\ri0\sl360\slmult1\keepn\widctlpar\aspalpha\aspnum\faauto\outlinelevel4\adjustright\rin0\lin0\itap0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\lang1024\langfe1024\noproof {\shp{\*\shpinst\shpleft-432\shptop22\shpright-144\shpbottom310\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz4\shplid1036{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn pictureDblCrMod}{\sv 271778803}}{\sp{\sn lineColor}{\sv 255}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn shadowType}{\sv 5}}{\sp{\sn shadowColor}{\sv 278462961}}{\sp{\sn shadowHighlight}{\sv 275121139}}{\sp{\sn shadowOffsetX}{\sv 12700}} {\sp{\sn shadowOffsetY}{\sv 12700}}{\sp{\sn fShadow}{\sv 1}}{\sp{\sn f3D}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8196\dprect\dpx-432\dpy22\dpxsize288\dpysize288 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinehollow}}} {\shp{\*\shpinst\shpleft0\shptop310\shpright10080\shpbottom1174\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz13\shplid1037{\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn lTxid}{\sv 524288}}{\sp{\sn fillColor}{\sv 14540253}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn lineColor}{\sv 9868950}}{\sp{\sn lineWidth}{\sv 38100}}{\sp{\sn lineStyle}{\sv 1}} {\sp{\sn fLine}{\sv 1}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\shptxt \pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 { \par }{\b\i MAJOR_____________________ EDUCATIONAL GOAL_____________________ DOB_____________________}{ \par }{\b\i \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab Proof required}{ \par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8205\dptxbx\dptxlrtb{\dptxbxtext\pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 { \par }{\b\i MAJOR_____________________ EDUCATIONAL GOAL_____________________ DOB_____________________}{ \par }{\b\i \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab Proof required}{ \par }}\dpx0\dpy310\dpxsize10080\dpysize864\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr221\dpfillbgcg221\dpfillbgcb221\dpfillpat1\dplinew60\dplinecor150\dplinecog150\dplinecob150}}}}{OTHER \par }\pard\plain \ql \li0\ri0\sl360\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs22 \tab }{\b\i\fs22 \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b\i \par \par }\pard \ql \li0\ri0\sl360\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b\i \par }\pard \ql \li0\ri-720\widctlpar\aspalpha\aspnum\faauto\adjustright\rin-720\lin0\itap0 {\lang1024\langfe1024\noproof {\shp{\*\shpinst\shpleft0\shptop708\shpright10080\shpbottom1646\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz12\shplid1038{\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn lTxid}{\sv 589824}}{\sp{\sn fFitShapeToText}{\sv 0}}{\sp{\sn fillColor}{\sv 14540253}}{\sp{\sn fillOpacity}{\sv 32768}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\shptxt \pard\plain \s4\qc \li0\ri0\keepn\widctlpar\aspalpha\aspnum\faauto\outlinelevel3\adjustright\rin0\lin0\itap0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {OFFICE USE ONLY\tab \par }\pard\plain \ql \li0\ri0\sb60\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\tab \tab \tab \tab \tab \tab \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {NEW RESIDENCY CODE_____________\tab OTHER____________________ VERIFIED ________________________ \par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8204\dptxbx\dptxlrtb{\dptxbxtext\pard\plain \s4\qc \li0\ri0\keepn\widctlpar\aspalpha\aspnum\faauto\outlinelevel3\adjustright\rin0\lin0\itap0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 { OFFICE USE ONLY\tab \par }\pard\plain \ql \li0\ri0\sb60\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\tab \tab \tab \tab \tab \tab \par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {NEW RESIDENCY CODE_____________\tab OTHER____________________ VERIFIED ________________________ \par }}\dpx0\dpy708\dpxsize10080\dpysize938\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr221\dpfillbgcg221\dpfillbgcb221\dpfillpat1\dplinehollow}}} {\shp{\*\shpinst\shpleft1296\shptop276\shpright8208\shpbottom661\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz5\shplid1039{\sp{\sn shapeType}{\sv 202}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn lTxid}{\sv 655360}}{\sp{\sn fFilled}{\sv 0}}{\sp{\sn fLine}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\shptxt \pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\b Mail to: Admissions and Records, 1500 N. Verdugo Rd., Glendale, CA 91208 \par }}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8197\dptxbx\dptxlrtb{\dptxbxtext\pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\b Mail to: Admissions and Records, 1500 N. Verdugo Rd., Glendale, CA 91208 \par }}\dpx1296\dpy276\dpxsize6912\dpysize385\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat0\dplinehollow}}}}{\b\i Student\rquote s Signature ________}{\b\i\fs22 _____________________________________________ Date___________________\tab \par }}