Step 4 - Meningococcal Vaccination Acknowledgement Form for Students Living in On-Campus Housing
If you will be living in on-campus housing, the State of Pennsylvania requires that you receive information about meningococcal meningitis and the vaccine and that you sign a document stating that they have either received a vaccination against meningococcal disease or reviewed the information and declined to be vaccinated. You should download, print and complete the following form:
Please mail this form directly to the Department of Housing Services at:
300 University Manor West
Hershey, PA 17033
To review important facts about meningococcal meningitis and meningococcal disease click here.
