SCXY Conference Mail List Change Form

This form may be used to make changes to your existing address/email information for SCXY conference mailing lists. Complete the hardcopy section for changes to your postal service mailings. Complete the email section for changes to your email mailings. Or, complete both sections to make changes to both.

HARDCOPY ADDRESS CHANGES

Please complete all requested address information. Note: old Zip/Post code is needed to resolve cases where someone else on a mail list has the same name as you.

Last name:
First name:
Organization:
Street:

City:
State/Province
Country:
Zip/Post code
Old Zip/Post code

EMAIL ADDRESS CHANGE

Your old email address will be replaced with your new email address on conference email lists. If you've already entered your name above, you need not enter it again here.

Last name:
First name:
New Email:
Old Email:

REVIEW / SEND YOUR REQUEST

Please review your information. Add any additional comments in the comments text area. Click on the submit button if all information is correct. To make corrections, you may re-type the information, or press the clear button below to start completely over.

Comments: