Change of Address Form for Individuals

Individuals may use this web form to provide an updated address for purposes of receiving the Extra Credit Grant.

First Name *

Last Name *

Last Four Digits of SSN *

Date of Birth *

Month

Day

Year

NC Driver’s License or ID Card Number *

New Address Line 1 *

New Address Line 2

City *

State *

Zip Code *

Enter 5-digit zip code.

Email Address *

Phone Number *

Do not include dashes.

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