Spring 2022 Re-entry: Negative Test or Positive 90 day reporting

Please submit documentation of a negative COVID test here. It must be dated no more than 5 days prior to your move-in. COVID tests must be issued by a medical provider/official testing site. Results submitted from over the counter test kits will not be accepted.

If you have been COVID-positive within 90 days prior to the start of the semester (AFTER October 31, 2021), please upload your positive result here.

If you are submitting a current positive test result, the Clinic Coordinator for Franklin College will be alerted of your result. Please isolate at home and someone will contact you regarding your next steps.

If you are an athlete, the Athletic Training staff will be alerted of your result.

If you are fully vaccinated, please submit your COVID vaccination record provided in the original link about re-entry.

Name Name First Last
Working cell phone number to reach you at: Working cell phone number to reach you at: - ### - ### ####
Franklin College e-mail address:
Permanent address: Permanent address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
I am a:

I am a: New Student (First year/Transfer) Returning Student
Please select your class status

Please select your class status undergraduate student graduate student Running Start Student Other: non-matriculated/adult leader/student auditing class
Do you live on campus?

Do you live on campus? I do not live on campus Campus homes Greek Housing Cline Dietz Center Elsey Johnson-Dietz Hoover
Are you a Franklin College athlete:

Are you a Franklin College athlete: Yes no
Please select which team(s) you belong to:

Please select which team(s) you belong to: Women's Swimming Men's Swimming Women's Basketball Men's Basketball Football Volleyball Women's Soccer Men's Soccer Baseball Women's Tennis Men's Tennis Lacrosse Softball Women's Golf Men's Golf Women's Cross Country/Track Women's Track Only Men's Cross Country/Track Men's Track Only
Are you enrolled in the Physician Assistant Masters program?

Are you enrolled in the Physician Assistant Masters program? Yes No
Are you enrolled in the Athletic Training Program?

Are you enrolled in the Athletic Training Program? Yes No
Have you received a positive COVID-19 test result within the past 90 days prior to the start of the semester? (Since October 31, 2021)

Have you received a positive COVID-19 test result within the past 90 days prior to the start of the semester? (Since October 31, 2021) No Yes
Date of your previous COVID-positive result (must be after October 31, 2021) Date of your previous COVID-positive result (must be after October 31, 2021) / MM / DD YYYY
Date of your most recent COVID-19 test. Must be dated on Wednesday January 26, 2022 or later. Date of your most recent COVID-19 test. Must be dated on Wednesday January 26, 2022 or later. / MM / DD YYYY
Results of your COVID-19 Test:

Results of your COVID-19 Test: Positive Negative
Please upload a screen shot of your test result/previous positive. It must include your name, date of test along with the result.

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