Webber International University - Emergency Contact Form for Students Residing On Campus

Emergency Contact Form for Students Residing On Campus

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Each students living in on-campus Housing (this includes off campus accommodation leased by the University) has the opportunity to register a confidential contact person, who will be notified in case he/she is determined missing. Contact of parents/guardians/emergency contact will depend on the accuracy of the information given by the student. It is also the student’s responsibility to update any and all contact information. Only authorized campus officials and law enforcement officers will have access to this information.

Student Name:
Emergency Contact:
Relation to Student:
Phone Number:
Student's Electronic Signature:
Date:

I understand that by completing and submitting this form, I allow University Officials and Law enforcement Officers to use the information in the event that I go missing during the period that I reside in University Housing. I understand that it is my responsibility to keep this information updated.