International Student Emergency Contact Form

International Student

Emergency Contact Form

(Please print clearly or type)

In case of emergency, we will contact your local sponsor. In addition, we need to have a contact

in your home country.

In case of emergency, please contact in home country:

Name: _____________________________________________________

Relationship to you (father, uncle, etc): ___________________________

Address: ____________________________________________________

City: _______________________________________________________

Country: ____________________________________________________

Phone Number: ______________________________________________

Fax: Email: __________________________________________________

Please complete and attach this form along with your application materials and transcripts.

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Parent category: Business