The Office of Student Engagement Anti-Hazing Registration Form 2026

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The document is an Anti-Hazing Registration Form from the Office of Student Engagement at Alcorn State University. It collects personal information from students, including contact details, major, and expected graduation date, while also requiring consent for the release of academic records for membership eligibility verification. A non-refundable registration fee of $25 is noted for departmental use.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your full name in the designated NAME field. Ensure that you provide your official name as it appears on your identification.
Next, fill in your A# (Alcorn ID number) in the corresponding field. This is essential for identification purposes.
Provide your cell phone number and email address. Make sure these are current so that the Office of Student Engagement can contact you if necessary.
Complete your address details, including city, state, and ZIP code. Accurate information is crucial for any correspondence.
List an emergency contact along with their phone number. This ensures that someone can be reached in case of an emergency.
Indicate your major and expected graduation date to help the office understand your academic background.
Read and sign the Alcorn Agreement Waiver, authorizing the release of your records for eligibility verification. Don’t forget to date your signature.
Finally, review all entered information for accuracy before submitting the form through our platform.

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How do I report hazing anonymously?

The Hotline provides an anonymous telephone line for anyone to report a suspected or recent hazing incident to one number 1-888-NOT-HAZE (1-888-668-4293) that accepts calls 24 hours a day. The Hotline connects to a dedicated voice mailbox at Manley Burke, LPA.

What can you do in your school organization, team, or club that would prevent hazing?

Preventing Hazing Be an active bystander. There are a number of ways to speak up and be a positive bystander, whether you do something directly, bring others in to help, or use an ingenious alternative to distract or disrupt a situation. Get involved. Lead by example. Support those who have experienced harm.