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University of Kentucy College of Dentistry 
Building a Foundation for the Future
 
Alumni

Alumni Address Change Form

If you have recently moved (either practice or residence) or haven't been getting mail, please complete the Alumni Address Change Form below.

First Name: 

Last Name: 

Last Name at Graduation (if different): 

Mail Preference (where you want to receive mail)  Practice   Residence

Residence - New Address

Street: 

City: 

State: 

Zip: 

Country: 

Phone: 

Practice - New Address

Street: 

City: 

State: 

Zip: 

Country: 

Phone: 

 

Email: 

What year did you graduate from UKCD?: 

Please feel free to add any special comments or ask any questions: 

Any comment will be forwarded to the correct person to respond to it.