Commuter Contact Information

Commuter Local Address Form

You are required to complete this form at the beginning of every semester that you are living off-campus. This address should be where you are living locally (apartment, home, etc.). Please do NOT list your campus mailing address, or your permanent home address unless you are living at home.

Student ID Number:*
First Name:*
Last Name:*
LETU Email:*
Telephone Number:*
The above listed phone number is a:*
Cell Phone
Land Line
Local Street Address:*
State: *
Zip Code:*
Name(s) of Roommate(s):

 All fields marked with an asterisk (*) are required.