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Contact a faculty or staff member form

Interested in contacting a faculty or staff member? Simply fill out the form below and we'll do the rest! The contact a faculty or staff member form enables you to also become a part of the Office of Admissions mailing list. Along with being contacted by a faculty or staff member, you will also receive the latest Elizabethtown College information through the U.S. mail.

• PLEASE NOTE: Fields designated with an * are required to submit the form.

LIST FACULTY OR STAFF MEMBERS:
	YES! I would like to contact a faculty or staff Member*.
Department*:

	I would like to contact a coach or conductor of a musical group.
Sport(s):
Musical Group(s):


PERSONAL DATA:
First Name*:
Middle Initial:
Last Name*:
Prefer to be called*:

	Sex*

Permanent home address*:
City*:
State*:
Zip Code*:
Country*:

E-mail Address*:
Confirm E-mail Address*:

Telephone*:

Academic major- first choice*:
Academic major- second choice*:


EDUCATIONAL DATA:
Name of high school*:
City of high school*:
State of high school*:
Year of high school graduation*:


EXTRACURRICULAR AND PERSONAL ACTIVITIES*:
Please list your principal extracurricular, community, and family activities and hobbies in the order of their interest to you. Include specific events and/or major accomplishments such as musical instrument played, varsity letters earned, etc. Please indicate (*) those activities you hope to pursue in college:


OPTIONAL SECTION:
If you wish to be identified with a particular ethnic group, please choose from the following:








Notice of Nondiscriminatory Policy: Elizabethtown College continues its policy of nondiscrimination on the basis of sex in compliance with Title IX of the education Amendment of 1972 in all activities and programs under its sponsorship. In addition, the College administers all actions without regard to race, creed, color, national origin, age or handicap as defined by law. These policies apply to application and selection as well as application fir employment and all other personnel actions with the College. Elizabethtown College is accredited by the Middle States Association of Colleges and Schools and is approved by the Department of Education, Commonwealth of Pennsylvania.
Elizabethtown College is a member of the National Association of College Admission Counselors and complies with the NACAC Statement of Principles of Good Practice.
Candidates for admission are entitled to receive copies of Elizabethtown College uniform crime reports and a statement of the institution's security policies and procedures. These documents are available upon request from the Office of Admissions 717-361-1400.