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Campus Access Request
This form is for any student who is currently residing off-campus, but wishes to have access to campus.
10
Questions
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1
Name
*
This field is required.
First Name
Middle Name
Last Name
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2
Lyon Email
*
This field is required.
example@example.com
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3
Lyon ID Number
*
This field is required.
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4
Reason for needing access:
*
This field is required.
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5
Locations need access to:
*
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6
Days/times needing access:
*
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7
Name of supervisor/instructor/coach who can confirm this need:
*
This field is required.
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8
Have you experienced any symptoms related to COVID-19 in the last 14 days?
*
This field is required.
YES
NO
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9
Have you been around anyone who has tested positive for COVID-19 in the last 14 days?
*
This field is required.
YES
NO
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10
Have you traveled outside Independence County in the last 14 days?
*
This field is required.
YES
NO
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11
Where, outside of Independence County, have you traveled in the last 14 days?
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