On-Campus Visitor Request Form

Important Notes

Masks and other required PPE must be worn. Students, employees, and visitors are required to practice social distancing and wear face masks when inside campus buildings, including in classrooms, labs, offices, and other public spaces, and the University is expecting that individuals also wear a mask when outdoors on campus and in the community.
If the event is on campus, work with the Office of Physical Plant to determine and ensure that the room capacity is appropriate for allowing the minimum required social distancing.
Approved visitors are scheduled with the full understanding that if the county in which the campus is located or the visitor’s county moves to the Yellow or Red phase, the guidelines for the county must be followed and the event may need to be cancelled.

Visitor Information

First Name

Last Name

Title/Role

Email Address

Phone Number

Organizer of the Visit

First Name

Last Name

Email Address

Phone Number

Briefly explain the purpose of the proposed visit.

Visit Details

Visit Location

Visit Start Time

Visit End Time

Provide a compelling reason for why the visit must take place face-to-face rather than virtually.

Provide the state and county the visitor is traveling from and all points visited 14-days prior to the proposed visit.

Concisely explain how the organizer will meet the state of Pennsylvania’s regulations for stopping the spread of the virus.*
See https://www.health.pa.gov/topics/disease/coronavirus/Pages/Stop-the-Spread.aspx for state requirements.

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