Chatham University

New & Transfer Student Orientation

Wednesday, August 21-Sunday, August 25

Click to download the 2013 Orientation Schedule

All new students are required to participate in the orientation program. Registration must be completed by Friday, August 9. This form will be reviewed by the Office of Student Affairs prior to orientation.

Questions?

Contact the Office of Student Affairs, Student Activities at studentactivities@chatham.edu or at 412-365-1281

Registration Form

Student Information

First Name :
Last Name :
Email :

Emergency and Parent/Guardian Contact Information

*This information will be used to inform your parents/guardians of Chatham Family & Friends Association membership, family and friends newsletters & activities. Contact information will not be shared with any third parties.

Primary Contact
Full Name :
Relationship :
Address :
City :
State :
Zip :
Phone :
Email :
Secondary Contact
Full Name :
Relationship :
Address :
City :
State :
Zip :
Phone :
Email :

Certain health/medical information must be made known to the instructor(s) conducting programs, so that they can be prepared to respond appropriately. This information will be held in confidence.

Do you have any allergies? (If yes, please list below)
Do you have any chronic conditions (asthma, diabetes, etc)? (If yes, please list below)
Are you taking any medications? (If yes, please list and indicate dosage and interval taken below)
Name any limiting physical and/or emotional disabilities or illnesses not already mentioned.
Religious Affiliation (OPTIONAL):
By selecting an religious affiliation you are granting Chatham University permission to release your contact information to members of the Chatham Multi-Faith Council.
Other :