IIE_Template - Change of Address - CollegeBoard

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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 internatonalteachers@iie.org. 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


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