Emergency Contacts

In the event of an emergency, we may need to contact a family member or friend on your behalf. To comply with FERPA (Family Educational Rights and Privacy Act), we are required to have you designate the people we may contact.

All students are required to supply at least one emergency contact person before beginning classes.

Student Information

First Name: *

Last Name: *

PID: * 🛈

Columbia Email: *

Home Phone:

Work Phone:

Mobile Phone: *

NYC (where living while enrolled) Mailing Address: *

City, State, Zip *

Emergency Contant Information:

Contact #1

Title: *

First Name: *

Last Name: *

Relationship to you (parent, spouse, partner, friend, etc): *

Home Phone:

Mobile Phone: *

Work Phone:

Email: *

Contact #2

Title:

First Name:

Last Name:

Relationship to you (parent, spouse, partner, friend, etc.)

Home Phone:

Mobile Phone: *

Work Phone:

Email: *

Notes:

Are you living in Columbia University housing? *

Are you living at I-House? *