Spring 2022 Arrival
Name
*
First Name
Last Name
Cell Phone Number
*
Please enter a valid phone number.
Student ID Number
*
Date of Birth
*
-
Month
-
Day
Year
Date
Return to Campus Date
*
-
Month
-
Day
Year
You must have approval from Residential Education to arrive prior to January 22, 2022.
Have you tested positive for COVID-19 in the last 90 days?
*
Yes
No
Date of COVID-19 Test
*
-
Month
-
Day
Year
Date
Upload a copy of your test results
*
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Negative PCR test result or any Positive test result
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of
Vaccination and Booster information
Please submit the dates of your vaccination and booster shots and upload a copy of your COVID-19 vaccination card.
Date of first vaccination shot
-
Month
-
Day
Year
Date
Date of second vaccination shot
-
Month
-
Day
Year
Date
Date of booster vaccination shot
-
Month
-
Day
Year
Date
Upload a copy of your COVID vaccination card
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Choose a file
Cancel
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Submit
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