Missing Student Contact Update

Missing Student Contact Update

Please identify an individual to be notified by the Dean for Student Development, Israel Chavez, if you are determined to be missing. If you are determined missing, the Dean will also notify the appropriate law enforcement agency no later than 24 hours after the time you are determined missing. In addition, if you are under 18 years of age and not an emancipated individual, the Dean is also required to notify your custodial parent or legal guardian if you are determined to be missing. If you are under 18 and not an emancipated individual, please signify below and complete the form with contact information for you custodial parent or legal guardian. (An "emancipated individual" refers to a minor who is self-supporting and independent of parental control, usually as a result of a court order.) If you are over 18, please complete the form below with contact information for whoever you would like to appoint as your missing person contact.
Student Name*

First NameLast Name
I am under 18 years of age.

YesNo
Student Email
example@example.com
Contact Information
Contact Name

First NameLast Name
Contact Relationship
Contact Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact Email*
example@example.com
Contact Phone Number

Area CodePhone Number
Should be Empty:

Contact Information