sibs.elmira.eduELMIRA COLLEGE - Siblings and Friends Weekend

Siblings & Friends Weekend Elmira College now accepts Siblings and Friends Weekend sign-up through this secure form. Please complete the information below and press the ’Submit’ button to confirm your attendance. Fields marked with an (*) are required. Elmira College Student Information *Name *Class Year ’16 ’17 ’18 ’19 Cell Phone *Email Address *Residence Hall Anderson Columbia Meier Perry Tompkins Twin Towers Non-residential Student Roommate(s) Name Roommate(s) consent to have guest Yes No Emergency Contact Name Relation Primary Phone Number Email Address Guest Information Name Relation Cell Phone Number Email Address Arrival Date Friday March 4th Saturday March 5th Accommodations Note: Siblings and friends between the ages of 12 – 25 are permitted to stay in the Residence Halls as a guest. Please note that there can be no more than 2 overnight guests per resident of a room. On-Campus Off-Campus Emergency Contact Name Relation Primary Phone Number Email Address Will an additional guest be attending? Yes No Second Guest Information Name Relation Cell Phone Number Email Address Arrival Date Friday March 4th Saturday March 5th Accommodations Note: Siblings and friends between the ages of 12 – 25 are permitted to stay in the Residence Halls as a guest. On-Campus Off-Campus Emergency Contact Name Relation Primary Phone Number Email Address Events Event Number Attending (Please include EC Student in count) Theme Dinner Friday Mar. 4th 5:00 p.m. Campus Center Dining Hall Air Plants & Music with AJ Smith Friday Mar. 4th 5:00 p.m. Campus Center Dining Hall Kid At Heart Night-Karaoke night and ice cream bar Fri. Mar. 4th 8:00—10:00 p.m. CC Mackenzie’s Pillow Pet & Film Screening of Shrek Saturday Mar. 5th 2:00 p.m. Campus Center Tifft Lounge Relay for Life Saturday Mar. 5th 7:00 p.m. Campus Center Dining Hall Note: Tickets available online through the American Cancer Society or for purchase at the door. Dueling Pianos at Relay for Life Saturday Mar. 5th 8:00 p.m. Campus Center Dining Hall Note: Performance as a part of Relay for Life. Tickets available online through the American Cancer Society or for purchase at the door. Brunch & Film Screening of Shrek Sunday Mar. 6th 11:00 a.m. Campus Center Dining Hall Meal Plans Meal Cost per ticket Number of Tickets (Note: Current EC Students do not need meal tickets) Price Theme Dinner Friday Mar. 4th 5:00 p.m. Campus Center Dining Hall $10 $0 Brunch Saturday Mar.5th Campus Center Dining Hall $7 $0 Dinner Saturday Mar. 5th Campus Center Dining Hall $7 $0 Brunch Sunday Mar. 6th Campus Center Dining Hall $10 $0 Total Charge Billing Information *Credit Card Type MasterCard Visa Discover AMEX *First Name (as it appears on the card) *Last Name (as it appears on the card) *Address *City *State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virgina Wisconsin Wyoming Ontario British Columbia Yukon Alberta *Zip Code Payment Amount *Credit Card Number *Expiration Date 01 02 03 04 05 06 07 08 09 10 11 12 / 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 *CVV2 Code (3-4 Digits) What is this? You may call or e-mail Sarah Finnefrock at (607) 735-1815 or sfinnefrock@elmira.edu with any questions X Please wait while your transaction is being processed. Elmira College | One Park Place | Elmira, New York 14901 | © 2020Elmira...