Ship CARES Referral Form

To refer a student to Ship CARES, please fill out all applicable information below. Once you have completed all required information, click the “Submit,” button to complete your referral.

Please note: Submissions to this form are received and reviewed during business hours only and are NOT monitored 24 hours a day. If your reason for making a referral is related to an emergency situation, please exit this form and contact either Shippensburg University Police (717-477-1444) or 911 immediately.

Your Information
Name:  
Relation to Student:
 
Email:       
Phone:       
Student You are Referring
First Name:
 
Middle Name:
 
Last Name:
 

Any Known Student Contact Information (phone number, email, etc.)

 

Student Residence (if known)


Briefly Describe Reason for Referral