Fisk University
Freshman Overnight Consent Form
Dear Fisk University Staff:
I, ________________________, the legal guardian of Fisk University
Student, _____________________________, hereby give my consent for
her/him to be off campus overnight on the following dates:
Departure Date Return Date
1.) _________________ 1.) ___________________
2.) _________________ 2.) ___________________
3.) _________________ 3.) ___________________
4.) _________________ 4.) ___________________
My student will be in the company of _________________________, and
he/she can be reached while away from campus at ( )______________.
My personal contact phone numbers are as follows:
Home Phone:________________________________
Work Phone:________________________________
Cell Phone:_________________________________
I understand that I may be called by Fisk University Staff prior, during, or
after my student’s departure from campus to confirm my student’s
whereabouts. I also agree to have this completed form delivered to the
campus 24 hours prior to my student’s departure.
Guardian’s Signature____________________________ Date ___________
Written notification must be received by mail or fax to the
attention of the Resident Director or to the Office of
Student Affairs 24 hours before departure!
Address: 1000 17
th
Ave. N Nashville, TN 37208 fax: (615) 329-8714
08/2003
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