Home Admissions New Students Academics Immigration Employment FormsHealth Insurance Exchange Students

Emergency Contact information

In case of an emergency, please complete and submit the form below. In the event that the emergency occurs after office hours which are Monday through Friday 8:00 a.m - 5:00 p.m., please contact the campus police/public safety: 657-278-2515. If it is a life-threatening emergency, please call the police 911.

CWID

(no dash)

First name:

Last Name:

E-mail:

Phone number:

(XXX-XXX-XXXX)

Emergency Contact Information in the United States

First name:

Last name:

E-mail:

Relationship:

Friend

Relative

Phone:

(XXX-XXX-XXXX)

Emergency Contact Information Outside the United States

First name:

Last name:

Email:

Relationship:

Friend

Relative

Country Code:

Phone number:

Fax number:

(Please include Country code)

This page is maintained by the Office of International Education & Exchange at Cal State Fullerton.
Contact the web administrator for comments and problems with the website.
California State University, Fullerton © 2005. All Rights Reserved.