University of New Mexico Police and Security

University of New Mexico Police and Security

SEX OFFENDER REGISTRATION FORM
UNIVERSITY OF NEW MEXICO POLICE DEPARTMENT
2500 Campus NE (Hokona Hall)
Albuquerque, NM 87131
505-277-2241 Dispatch
http://police.unm.edu

Date Submitted: *

Legal Full Name: *


ADDRESS INFORMATION:

Email Address: *

Please Re-type Your Email Address: *

Current Address: *

City: *
State: *

Zip Code: *


Permanent Mailing Address :

City: 

State:

Zip Code:


Date of Birth: *

SEX OFFENSE CONVICTION INFORMATION:

Charge: *

Date of Conviction: *

Place of Conviction: *


CLASSIFICATION: *
Student Staff  Faculty Other: 

If Other, please describe below. (This category may include volunteers, or UNM contractors - If you are a volunteer or UNM contract employee, provide organization or company name.)


* During your affiliation with the University, you are required to update your information with Campus Police or the Registrar's Office within 10 days after the change occurs.

I certify that all the information given in this registration is complete and accurate.