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COVID-19 - USP LAUCALA Students Contact Database
Please complete the survey below. All information will be kept confidential and shall be used for the purpose of evacuation logistics if required.
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1.
Name as shown on passport
(Required.)
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2.
USP Student ID number
(Required.)
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3.
Nationality as shown on current valid passport
(Required.)
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4.
Phone Contact
(Required.)
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5.
Alternative Phone Contact (Emergency)
(Required.)
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6.
Current Physical Address
(Required.)
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7.
Emergency contact details
(Required.)
Name
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Address
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City/Town
Country
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Email Address
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Phone Number
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8.
Country of Usual Residence
(Required.)
*
9.
Are you a private/sponsored student?
(Required.)
Private
Sponsored (please provide Sponsor's Name & Contact Details)
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