Residential Stay - Spring 2020
The Office of Campus Life would like to be informed of students living and staying on campus at the time of this rapid change and uncertainty. We are collecting this information in case of emergency and if there should be a state wide shutdown or shelter in place. If you are staying in your residential living assignment at this time, please fill out this form.

The state mandated "stay at home" order goes into effect, Saturday, March 21st at 5 p.m.
Email address *
First Name *
Your answer
Last Name *
Your answer
Cell Phone *
Your answer
Hall *
Room/Apartment Number *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Medical Needs? *
Your answer
As a student who is remaining on campus, I understand that Millikin University is following CDC guidelines regarding social distancing. Gatherings will not be permitted. I also agree not to have any guests during this time to keep myself and others safe within this shared space. Hence, by completing this form, I acknowledge my intent to abide by these guidelines. *
Should the State of Illinois enact a "shelter in place" order, Millikin University will continue to provide essential, but limited services. By placing my name below, I understand this information. *
Your answer
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