Biographic/Demographic Survey

This form is required of all students prior to starting coursework at the University of Connecticut School of Law. The information gathered is used to update a student’s profile in the student administration system database and for statistical purposes. Please note student directory information, including some of the data requested on this form (Name, Address, Telephone Number, and Program of Study) may be provided upon request to members outside of the community of the School of Law as permitted under the Family Educational Rights and Privacy (or FERPA) of 1974. Students wishing to limit the disclosure of this information must file a written request with the Office of the Registrar on an annual basis.

Biographical Information
Temporary aliens must complete the INS Biographic form.
Ethnicity
If yes ...
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Mailing/Billing address and Telephone
Home/Permanent Address and Telephone
Business Address and Telephone
Health Information/Immunization

Connecticut state law requires that all matriculating students at post-secondary schools in the state provide proof that he/she meets the criteria of adequate immunization. This form is required of all students prior to starting coursework at the University of Connecticut School of Law. The information gathered is used for statistical purposes. Personally identifiable information will be kept confidential unless in cases of serious health emergency or outbreak

State law defines adequate immunization as any of the following

  • An affidavit signed by a physician/nurse practitioner that indicates that a blood test shows measles and rubella immunity.
  • Verifiable proof that a student has had two doses of measles vaccine at least one month apart (the first does must have been received after 1968, the second dose must have been received on/after January 1, 1980), and one does of rubella vaccine.
  • Graduation from a public or non-public high school in the state of Connecticut in 1999 or later.
  • An affidavit signed by the student that indicates that he/she will not receive vaccines on religious grounds.
  • An affidavit signed by a physician/nurse practitioner that indicates that vaccination is medically inadvisable and the reasons for the same.

Persons born before January 1, 1957 are exempt from this requirement as they are presumed to be naturally immune.

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