Short-term Off-campus Engagement Request Form
Please complete this form to request permission for a one-time essential off-campus engagement (ie. funeral, wedding, medical appointment requiring an overnight stay). Currently, a student may re-enter campus after a 7-day quarantine with a negative COVID-19 test taken at day 5 OR a 10-day quarantine with a negative test taken at day 7. Students are responsible for the cost of re-entry testing. (Please note: Because of the continually evolving nature of the virus and the pandemic, the quarantine and testing requirements may change at any point even after a student has been granted approval to attend the event.)
Name
*
First Name
Last Name
Wheaton Email
*
example@my.wheaton.edu
Student ID #
*
Spring semester housing address (off-campus street address and unit # OR on-campus building, room/apt #)
*
Are you a varsity athlete?
*
Yes, fall sports
Yes, winter sports
Yes, spring sports
No
Are you a music student at Wheaton College?
*
Yes
No
Type of off-campus event
*
Funeral
Wedding
Medical appointment or procedure
City and State where event is located
*
City, State
How many people are expected at this gathering?
*
What is the date(s) of the event you will be attending?
What date will you be leaving campus to attend the event?
-
Month
-
Day
Year
Date
What is the last date of the event you are attending?
-
Month
-
Day
Year
Date
Additional comments that will assist with our review of your request, including the COVID safety plans for the event you hope to attend. (i.e., will you be wearing masks, social distancing, adhering to capacity guidelines, engaging outside when possible?)
*
Name of emergency contact
*
Emergency contact phone number
*
-
Area Code
Phone Number
*
I understand that upon approval of my request, I will be required to quarantine for 7-10 days at home after the last date of exposure to any large gathering or overnight stay before traveling back COVID-safely to campus. I will also be required to obtain a COVID test on day 5 of a 7-day quarantine OR day 7 of a 10-day quarantine and to submit a negative COVID-19 test to covid.test@wheaton.edu prior to my return. I understand that I will need to continue attending my classes remotely during the quarantine time. If my test is positive, SHS will inform me of the date I can return to campus.
Submit
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