Student Information Update

Update Registration Information Please submit only information that is new. Submit more than once as necessary. If you have any additional questions, please contact the Registrar Mrs. Colleen Rozman at cmrozman@mhsmi.org.

Submitter's Name * First Last
Submitter's Email *
Student's Name * First Last
Student's Middle Name First Last
Current Grade *
Advisor's Name * First Last
Parent/Guardian Name (previous) First Last
Parent/Guardian Name (current) First Last
Email (previous)
Email (current)
Phone (previous) - (###) - ### ####
Phone (current) - (###) - ### ####
Address (previous)
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Address (current)
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Effective Date * / MM / DD YYYY