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Please submit the following form if you wish to receive emergency or critical information updates from NCCU.

Select the group to which you belong and click "Go" to update the form.
Fill in the form.
- If you are a Student, Faculty/Staff, or Family of a Student, please provide the email address you are most likely to check frequently.
- Emergency phone numbers should be entered as follows:
  - Phone: Cell/mobile
  - Phone 2: Work or Residence
  - Phone 3: Work or Residence

Note: maroon fields are required.

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First Name:

Last Name:

Email:

Phone:

Phone 2:

Phone 3:

Fax:

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