Change of Address Form

P.S.A.C. ID #

Salutation

First Name

Last Name

Old Address

Old Address Line 1

Old Address Line 2

Old City

Old Province

Old Postal Code

New Address Line 1

New Address Line 2

New City

New Province

New Postal Code

Home Phone

Work Phone

Local

IAN #

Employer/Dept

Language

English

French

Are you a member of the PSAC?

Yes

Would you like to become a member in good standing?

Yes, please send me an application card.

Request ID card

Yes, please send me my PSAC ID card.

Please also notify your local of your change of address and if you receive mail regularly from the regional PSAC office please advise them as well.