Emergency Alert

Name*
Position at Bethel*
E-mail*
Phone 1*
Contact Name
Contact Cell Number
Contact Fax
Contact Home Number
Contact Work Number
Contact 2 Name
Contact 2 Cell Number
Contact 2 Fax
Contact 2 Home Number
Contact 2 Work Number
My contact information has changed so update existing records
Please remove all contact information.
Please answer the simple math question below to submit the form.
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