Info For
Search
Office Directory
Info For
COVID-19
Parents
Faculty & Staff
Current Students
Online
Undergraduate Programs
COVID-19
About
Hilbert 2025 | Strategic Plan
Mission & Vision
Office of the President
Conferences & Events
Fast Facts
History & Traditions
Visiting Hilbert
Virtual Tour
Employment & Benefits
Consumer Disclosure
Notice of Non-Discrimination
Institutional Research & Assessment
Directory
Ten Things About Hilbert
Conduct at Hilbert College
Academics
Undergraduate Programs
Pre-Professional Programs
Master's Programs
Online Opportunities
Pre-College Programs
Summer Sessions
Student Services
Library
Commencement
Value of Hilbert Education
College Catalog
Honors Program
Hilbert Blueprint
Academic Calendar
Academic Policies & Procedures
Liberal Learning Outcomes
Admissions & Aid
Apply to Hilbert
Schedule a Visit
Undergraduate Admissions
Graduate Admissions
Financial Aid & Costs
Summer Classes @ Hilbert
Accepted Students
Digital Campus Initiative
Student Life
Campus Safety
Student Activities
Living on Campus
Athletics
Diversity & Inclusion
Leadership
Campus Ministry
Counseling Center
Health & Wellness Center
Veterans
Student Services
Bookstore
Service Learning
New Student Orientation
International Education
Transportation
Army ROTC
Athletics
Alumni
Ways to Give
Scholarships
News & Updates
Events
Visits
Give Now
Home
/
Admissions & Aid
/
Accepted Students
/
Enrollment Kit
/
Emergency Contact Form
Enrollment Kit
Emergency Contact Form
Orientation Session Form
Housing Application
Roommate Preference Form
Student Medical Form
Accessibility Services Form
Mental Health Form
Student Life Survey
Campus Ministry Survey
Contact Us
Hilbert College
Office of Admissions
5200 South Park Ave.
Hamburg, NY 14075
Franciscan Hall, First Floor
Phone: (716) 926-8780
Toll Free: 1-800-649-8003
Text: (716) 296-4350
Fax: (716) 649-0702
admissions@hilbert.edu
Office Hours
Monday - Thursday: 8:30am - 5pm
Friday: 8:30am - 4:30pm
Enrollment Kit - Emergency Contact Form
REQUIRED OF ALL STUDENTS. THIS FORM MUST BE SUBMITTED PRIOR TO START OF THE SEMESTER.
Please list your emergency contact information in the event of an emergency or life-threatening situation.
Student First Name
Click to add
(?)
Student Last Name
Click to add
(?)
Date of Birth
Click to add
XX/XX/XXXX
(?)
Street Address
Click to add
Street, City, State, Zip Code
(?)
Student Living
On-Campus
Off-Campus Commuter
PRIMARY EMERGENCY CONTACT
Full Name
Click to add
(?)
Relationship
Click to add
(?)
Primary Phone or Cell
Click to add
XXX-XXX-XXXX
(?)
Secondary Phone
Click to add
XXX-XXX-XXXX
(?)
E-Mail
Click to add
(?)
SECONDARY EMERGENCY CONTACT
Full Name
Click to add
(?)
Relationship
Click to add
(?)
Primary Phone or Cell
Click to add
XXX-XXX-XXXX
(?)
Secondary Phone
Click to add
XXX-XXX-XXXX
(?)
E-Mail
Click to add
(?)
Generate New Image
Type the code from the image
FOR MORE INFORMATION
Barb DeLaRosa • (716) 649-7900, ext. 123 •
bdelarosa@hilbert.edu