Emergency Notification System

Community Member Emergency Contact Information

Please fill out the form and submit. This information will be used to contact you in case of emergency such as a campus closure announcement due to adverse weather or Pandemic flu outbreak.

If you are a student, staff, or faculty of UCC, please use the form within UCCLife.

NOTE: Fields with an asterisk (*) are required.

*First Name:
*Last Name:
Gender:	Male Female
Status:
*Home Phone:	(555) 555-5555 format
Work Phone:	(555) 555-5555 format
Mobile Phone:	(555) 555-5555 format
Text Messaging enabled Phone: (Standard texting rates may apply.)	(555) 555-5555 format
Email Address:
Removal Request:	Yes, please remove my account from the emergency notification list.

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