/ Student Life/ Templeton Locker Application

Templeton Locker Application

All fields marked with asterisk (*) are required.

required date field

Date*

Date of request

required text field

First Name*

Please enter your first name.

required text field

Last Name*

Please enter your last name.

required e-mail address field

Email Address*

Please use your Lewis & Clark Email

required text field

Phone Number*

Please use your cell phone umber

required text field

Student Organization Name*

If this application is for personal use, please enter N/A on this line.

e-mail address field

Student Organization Email Address

Please use your organization's email address. If this application is for personal use, please leave this line blank.

Link (required)

Vice President of Student Life and Dean of Students is located in East Hall on the Undergraduate Campus.
MSC: 102

email vpsl@lclark.edu

voice 503-768-7110

Vice President of Student Life and Dean of Students
Dr. Evette Castillo Clark

Vice President of Student Life and Dean of Students
Lewis & Clark
615 S. Palatine Hill Road MSC 102
Portland OR 97219