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S E A R C H   S I T E
S E A R C H   W E B
     
Student Services
P E R S O N A L   I N F O R M A T I O N
The information will be sent by email to the student and to the Dean of Student's Office. In emergency it may be shared with the CTS security office and the RA's.
Class Level
Students
NAME
STUDENT ID #D000
HOME CHURCH
CITY & STATE
HOME DISTRICT
Ft Wayne Information
ADDRESS
CITY & STATE
ZIP
PHONE
E-MAIL
Spouse
MARITAL STATUS Single     Married
SPOUSE'S FIRST NAME
Spouse's Employer
ADDRESS
CITY & STATE
PHONE
Children
NAME AGE
Doctor
NAME
ADDRESS
PHONE
Emergency Contact
NAME
RELATIONSHIP
ADDRESS
CITY
STATE-ZIP
PHONE
Emergency Contact 2
NAME
RELATIONSHIP
ADDRESS
CITY
STATE-ZIP
PHONE
Student's Parents
NAME(S)
ADDRESS
CITY & STATE
ZIP
Spouse's Parents
NAME(S)
ADDRESS
CITY & STATE
ZIP
Medical Information
List Allergies:
List any medical condition emergency personnel need to know:

All information must be filled out and completed! Please contact the Dean of Student's Office for further assistance. Mi Young Chung or (260)452-2157
 
 
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Further Information: Public Relations
 6600 North Clinton Street
Fort Wayne, IN 46825
(260) 452-2100
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