Lactation Room Registration Form - southernct 2026

1. Click ‘Get Form’ to open the Lactation Room Registration Form in the editor.
2. Begin by entering the date at the top of the form. This helps track when you submitted your registration.
3. Fill in your name, SCSU email, and phone number. Providing accurate contact information is essential for communication.
4. Complete the department and Banner ID # fields to ensure proper identification within the university system.
5. Indicate your employment status by marking whether you are staff or faculty, and specify if you are full-time or part-time.
6. Provide your expected date of birth and anticipated return-to-work date. This information is vital for planning purposes.
7. In the section regarding room usage frequency, share how often you plan to utilize the lactation room.
8. Describe any challenges or support you've encountered while pumping at work in the designated area.
9. If applicable, explain what actions you would take if the lactation room were unavailable.
10. Add any additional comments, questions, or concerns in the provided space before signing and dating the form at the bottom.

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