Emergency Contact / Missing Person Registration

Please provide the names and phone numbers of those individuals whom you want to be notified in the event of an emergency. By federal requirement, the Missing Student Contact persons list must be kept separate from the Emergency Contact persons list, although they may have identical people listed. The first three persons listed will be those who are contacted for any general emergency situation (medical emergency, etc.). The second three persons listed will be those who are contacted only if you would become a missing student. At least one contact name and phone number for each category (Emergency and Missing Student) is required. Please verify that all phone numbers are typed in correctly.
In the Event of Emergency
First Contact Name*
First Contact Phone*
Second Contact Name
Second Contact Phone
Third Contact Name
Third Contact Phone
Missing Student Contacts
First Notification Name*
First Notification Phone*
Second Notification Name
Second Notification Phone
Third Notification Name
Third Notification Phone

CTSFW