Anthropology Department

Anthropology Department

Student Information Form

Name: / Student ID #
Last / First / MI
Local Address
Street / City / State / Zip
NAU E-mail / Local Phone
Off campus e-mail / Cell Phone
Permanent
Address / Street / City / State / Zip

Emergency Contacts

Person (s) Who can contact You for Us
Names / Phone
Address
Street / City / State / Zip
Person (s) Whom We should contact for You
Names / Phone
Address
Street / City / State / Zip

Student Classification

Undergraduate / Graduate / Track / Subfield
Major / Extended Major
International Cultural immersion Major
Double Major (degree) with ______
BAiLS / Research (Thesis)
Applied / Archaeology
Cultural
Linguistic

* * * * * * * Information Release * * * * * * * *

Information that may be released to general Inquiries

Local Phone Cell Phone e-mail address (s) Local Address Permanent Address All None

Information that may be released to Fellow Students and university personnel

Local Phone Cell Phone e-mail address (s) Local Address Permanent Address All None