Report address/phone change

Personal Particulars

Surname:

First Name:

Student / Staff number:

Status:

If other, please explain:

If this change is temporary, fill out the effective dates

Start Date:

Now

End Date:

Now

Email Address:

Preffered method of notification:

New Address (your library mail will be sent to this address)

Address:

Postal Code or Campus Building Code:

Daytime Tel / Cell:

Evening Tel / Cell:

Patron Barcode:

Library you deal with:

Anti Spam:

Enter security code:

Tel: +27 (0) 41 504 1111

Fax: +27 (0) 41 504 2574 / 2731

PO Box 77000, Nelson Mandela University

Gqeberha, 6031, South Africa

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