First Name*

Last Name*

Date of Birth*

Gender*

Address*

City*

State*

Zip*

County*

Home Phone*

Cell Phone

Email*

Name of High School / College Attended*

Year of High School Graduation*

Have you attempted or completed college credit AFTER high school graduation?*

If so, please list name(s) of colleges/universities you've attended

Intended Major*

Interested in Academic Department Meeting if available?*

(When possible, Department Meetings are scheduled prior to the 1:00 p.m. tour)

Appointments are currently offered Mondays, Wednesdays, and Fridays at 1:00 p.m. What date would you like to visit?

1st Choice*

2nd Choice

3rd Choice

Special Accommodation/Accessibility Required

Additional Comments

Student T-shirt Size*

Feel free to call us at 1-800-577-6826 Monday - Friday, 8:00 a.m. to 4:00 p.m. if assistance is needed in scheduling your appointment.?

Admissions Appointment Request