This form is only for organizations who are moving locations. If you are a proctor changing organizations, please fill out a new proctor application. Name * Organization * Birthdate We use this to verify we are changing the record of the correct person. Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025 Business Email * Business Phone * Please enter your new mailing address * Street City, State, Zip Country Physical address for express mail (if different) Reason for address change * By submitting this form I (and my parent/guardian if I am a minor) give BYU permission to process, transfer, and use my personal information in accordance with the BYU Privacy Notice. I (and my parent/guardian if I am a minor) understand my information may be transferred, processed, and stored via third-party servers, and could potentially be viewed by others.