Orientation Registration Form

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Registration Form for ACCEL® Orientation  (please print)

 

Name: ___________________________________ Department: ___________

 

Address: ____________________________________________________________  

 

City: __________________________  Street ________  Zip ___________

 

Phone (day): _____________________ (evening): ______________________

 

E-mail: _____________________________________________________________    

 

Please specify if you want an on-campus orientation, or a telephone orientation:    

 

_____________________________________________________________  

 

NOTE: For telephone orientations, please allow 4 to 5 days to allow materials to be delivered via USPS.

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Submit by mail to: Office of Curriculum Development & Support 

                                  1145 King Road   L-213     

                                  Immaculata, PA 19345-0664

Or submit electronically to:       Fax: 610-251-1668       E-mail: vshay@immaculata.edu   Phone: 610-647-4400 ext. 3062, 3153 or 3033  

For internal use only:

CANON: Please deliver to Lourdes, Room 213.  Thank you!

1145 King Road, Immaculata, PA. 19345
p. 610-647-4400 or call toll-free: 1-877-42 TODAY
Federal Compliance Links | Clery
Copyright ©2014 All Rights Reserved

1145 King Road, Immaculata, PA. 19345 p. 610-647-4400 or call toll-free: 1-877-42 TODAY
Immaculata University | Copyright ©2014 All Rights Reserved | Federal Compliance Links | Clery