If you will be on campus at any time during break, you must complete this form and submit it no later than 12 noon on Tuesday, November 20th.
* First Name
* Last Name
* Phone #(555) 555-5555
* Room/Apt #
* If you would like to spend Thanksgiving meal with a faculty/staff member check the box below and your name will be forwarded to the Office of the Dean of Student Affairs. You will be contacted by a faculty/staff member who has volunteered to host a student for the Thanksgiving meal.
700 College Place
Williamsport, PA 17701
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