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CLASSE Short Term Visitor Agreement/Safety Form
The purpose of this form is to verify that, as a short term visitor, you have received the required safety information and are aware of
as it pertains to your visit. You may need to consult with your CLASSE host while filling this out.
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NOT with the back/forward buttons at the upper left corner of your browser!
Please enter the requested information.
Telephone contact #
Visit start date (mm/dd/yyyy)
Visit end date (mm/dd/yyyy)
CLASSE Host Name
CLASSE Host Email address
Purpose of visit (brief)
Please indicate what CLASSE building(s)
and room number(s)
your visit will include,
including those visited only as part of an escorted tour
(check/fill in all that apply)
Physical Sciences Building
Other (please indicate)
Please select one of the choices below.
I am a vendor, a contractor, or a Cornell employee or student not affiliated with CLASSE
I am NOT a vendor, a contractor, or a Cornell employee/student.
Please select one of the following choices:
I am 18 years of age or older
I am under 18 years of age
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