Forms

Activities and Religious Preference Interests

Name


Many of you have been involved in regular activities in your high school experience. Please check the topics in which you would be most interested in participating.


INVOLVEMENT INTEREST


Leadership Clubs and Organizations Global Exposure

 


RELIGIOUS AND SPIRITUAL INTERESTS

 

The college has no religious affiliation, and participation is a matter of personal choice. The College Chaplain tries to insure that students have the opportunity to practice their faith and explore spiritual values during their time at Wells. Completion of this form will allow the Chaplain to help meet your religious and spiritual needs during your time at Wells.


Religious Preference

Please check all that apply:


Attending Religious Services

Baptist

Spiritual Exploration

Buddhist

Fellowship and Song

Catholic

Fellowship of Christian Athletes

Episcopal

Religious Study

Evangelical

Hindu

Jewish

Methodist

Muslim

Orthodox

Pagan

Pentecostal

 Presbyterian Protestant Unitarian Universalist

United Church of Christ

 None

 

 

Other:

 

CLUBS AND ORGANIZATIONS

Please check all that apply:

 

Performance Groups Athletics / Recreation Groups

Appointed Gospel Choir

Outdoor Climbing

Bell Ringers

Wells College Paintball Club

Burlesque Troupe

Wells College Rugby Club

Whirligigs, a capella group

  

Dance Collective

  

Henry's VIII, a capella group

  

Prodigy Dance Club

  
   
Cultural, Diversity and Global Exposure Groups Publications / Media Groups

Japanese Culture Club

Film Production Club

Praising Our Work, Ethnicity, and Race (POWER)

Cardinal, the yearbook

Mahogany

Chronicle, literary publication

Sex Collective

The Sycamore, magazine publication

Sexuality and Gender Activists (SAGA)

  

Wells International Student Association

  

Women's Resource Center

  

Umoja

  
   
Social and Special Interest Groups Service Groups

Knitting, Needlework, and Other Tatting (KNOT)

Community Service and Activism Board

Bookworms

Dream Catalyst

Programming Board

Red Cross Club

Sugar High, baking club

  

Model United Nations

  

Wells College Debate Team

  

Political Activism at Wells (PAW)

  
   
Academic Clubs Environmental Groups

Psychology Club

Campus Greens, environmental group

Spanish Club

Collegiate 4-H
 

Lake Dogs
 

Wells FORCES (Friends of Recreation, Conservation, and Environmental Stewardship)
   

 

Emergency Contact Form

Medical Information and Emergency Contact Form
Student Information
Name Nickname
Street, City, State, Zip
Home Phone Cell Phone
Date of Birth Place of Birth
Email Address Sport (if applicable)
Expected Graduation Year
Medical Information
Known allergies/allergies to medication
Medical conditions
Medications currently taking
Last tetanus shot
Primary Care Physician Information
Name  Telephone 
Street, City, State, Zip
Medical Insurance Information
Parent/Guardian Insurance Provider
Policy Holder Name Policy/Suscriber Number
Street, City, State, Zip of Insurance Provider
Emergency Contact Info
Contact #1
Name  Relationship to you 
Home Telephone  Cell Phone 
Work Phone  Do you live with this person? Yes  No
Email 
Street, City, State, Zip
Contact #2
Name Relationship to you
Home Telephone Cell Phone
Work Phone Do you live with this person?Yes No
Email 
Street, City, State, Zip