To: International Programs & Services

* Indicates a required field.

*Today’s Date (MM/DD/YYYY):
*Last/Family Name:
*First/Given Name:
*SJSU Student ID #:
* Gender:		Male   Female
*Email Address:
*Telephone Number:
*New Address:
*City:
*State:
*Zip:

Be sure to update your address in your MySJSU record.

 I certify that the above information is true and correct.