CSM Contact Information and Residency Status Update Form

1
Student Name* This field is required.
First Name
Middle Name
Last Name
2
CSM Student ID Number (optional)
3
Student Date of Birth* This field is required.
Date
Month
Day
Year
4
Student Email* This field is required.
example@email.com
5
Last Four Digits of Student Social Security Number* This field is required.
6
What Updates to Your Student Record Would You Like to Make?* This field is required.
Name Change
Address/Residency Change
Telephone Number Change
Email Change
7
What is Your Former Name?* This field is required.
First Name
Last Name
8
What is Your New Name?* This field is required.
First Name
Last Name
9
Name Change Verification* This field is required.To update your name, please submit an official government document that shows your name as it is currently. This can be one (1) of the following: - Driver's License (Front and Back) - Court Document (Marriage certificates cannot be accepted) - Updated Social Security Card
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
10
Which option below best describes your address change situation?* This field is required."Tri-County Area" is defined as Calvert, Charles, or St. Mary's Counties.
I previously lived outside of MD/or the tri-county area, and have moved into MD/or the tri-county area.
I previously resided within the tri-county area, and have moved within, or out of, the tri-county area.
11
What is Your Previous Address?* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
12
What is Your New Address?* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
13
(Not Used)Address Change VerificationIf you have moved into the area from outside of the tri-county area, you must submit two (2) of the following documents listed below. Both submitted documents need to include your name, your address, and MUST be dated three (3) months prior to the start of the semester to receive the appropriate tuition rates. - Maryland Driver's License (Front and Back - Must also submit MVA provided address correction if license does not reflect current address) - Maryland Vehicle Registration - Military Orders (Military dependents must also submit Military ID) - Voter's Registration - Current Lease or Deed of Residence - Prior Year's Federal or State Income Tax Returns (Proper returns only, not separate forms such as W-2, etc.) - Pay Stub OR Checking/Savings Statement Please note that any updates to your residency will only be made for future academic terms. Tuition rates received after updating residency cannot be applied retroactively to previous terms and tuition rates. If you have questions about the required forms, or are unsure about whether a document qualifies, please contact us at askme@csmd.edu or 301-934-2251, option 0.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
14
Address Change Verification* This field is required.If you were previously a resident of the tri-county area, and have moved within the area, or have moved outside of the area, please submit one of the following document types listed below. The document must include your name and address. - Driver's License, Learner's Permit, or State Identification Card (Front and Back - Must also submit MVA provided address correction if license does not reflect current address) - Maryland Vehicle Registration - Military Orders (Military dependents must also submit Military ID) - Voter's Registration - Current Lease or Deed of Residence - Prior Year's Federal or State Income Tax Returns (Proper returns only, not separate forms such as W-2, etc.) - Pay Stub OR Checking/Savings Statement If you have questions about the required forms, or are unsure about whether a document qualifies, please contact us at askme@csmd.edu or 301-934-2251, option 0.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
15
Residency Verification* This field is required.If you previously lived outside of the tri-county area, but have now moved within the tri-county area and have resided in-county for at least three months, your residency status may be updated. To update your residency status to receive in-county tuition rates, you must submit two (2) of the following documents listed below. Both submitted documents need to include your name, your address, and MUST be dated three (3) months prior to the start of the semester to receive the appropriate tuition rates. - Driver's License, Learner's Permit, or State Identification Card (Front and Back - Must also submit MVA provided address correction if license does not reflect current address) - Maryland Vehicle Registration - Military Orders (Military dependents must also submit Military ID) - Voter's Registration - Current Lease or Deed of Residence - Prior Year's Federal or State Income Tax Returns (Proper returns only, not separate forms such as W-2, etc.) - Pay Stub OR Checking/Savings Statement Please note that any updates to your residency will only be made for future academic terms. Tuition rates received after updating residency cannot be applied retroactively to previous terms and tuition rates. If you have questions about the required forms, or are unsure about whether a document qualifies, please contact us at askme@csmd.edu or 301-934-2251, option 0.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
16
Residency Status Tuition Update Understanding* This field is required.I understand and acknowledge that any updates to made to my residency status as a result of my submission of this form and accompanying document submissions will only take effect for future academic terms, and that tuition rates received after updating residency will not be applied retroactively to previous terms and tuition rates.
17
What is Your Previous Phone Number?* This field is required.Please enter your previous phone number below, and select whether this was a day, evening, or cell number
Please Select
Please Select
Day
Evening
Cell Phone
18
What is Your New Phone Number?* This field is required.Please enter your new phone number below, and select whether this is day, evening, or cell number.
Please Select
Please Select
Day
Evening
Cellphone
19
What is Your Previous Email Address?* This field is required.
example@example.com
20
What is Your New Email Address?* This field is required.
example@example.com
21
Email Address Change Verification* This field is required.Any change to your personal email MUST include a copy of one of the following: - A government issued Photo ID (Front and Back) - Your CSM Student ID card
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
22
Signature* This field is required.Please sign below, indicating that you approve of any requested changes and that you have provided any required documents.
Clear
Should be Empty: