Emergency Notification Form


Please complete the following information so Bethel can compile its emergency notification services datatabase and please list additional emergency contact names on a new form and submit separately.  For questions, call 731-352-4259.

If an emergency situation were to occur, please list the emergency contact name you would like for our emergency notfication service to contact for you. Please give area codes for all phone numbers listed.

Disclaimer:  Each student will be responsible for notifying the Security Office if there are phone number changes or emergency contact number changes.  It is also your responsibility to notify Security to have your information removed when you leave Bethel.
My contact information has changed so update existing records.
Please remove all contact information.