Student On Campus Emergency Registration Form
By completing this form I am stating that I am unable to leave campus and intend to remain in my on campus residence (ie. residence hall or Greek chapter house), throughout this weather emergency due to hurricane Sandy.
Cell Phone Number
This should be a number that Lehigh administrators can reach you at for updates
Campus Residence Hall & Room Number
Please indicate your hall name and room number (ex. Kappa Sigma, 210 or M&M B310)
Emergency Contact Name
This should be the name of a parent or legal guardian
Emergency Contact Phone Number
This should be the cell phone number of the above emergency contact
Never submit passwords through Google Forms.
Terms of Service