This form will be placed in your file and will also be kept in a backup location in the event of an emergency.
Medical Background - Disclosure is optional
In an emergency we will contact the person(s) whose name(s) you provide in the Emergency Contact Section. Please notify your emergency contact(s) about this designation.
In the event of an emergency, I authorize release of the above information:
Meet our community
Kickstart your future
Refer a student
Make your gift now