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Premier Weekend Registration Form

Visit Registration Form:

1.
*

Choose a date:

 (1 required)
October 1-2, 2010
November 5-6, 2010
February 11-12, 2011
March 18-19, 2011
Other
2.

If other, what dates would you like to visit?
3.
*

First Name
4.
*

Last Name
5.
*

Phone Number
6.
*

Street Address
7.
*

City
8.
*

State
9.
*

Zip Code
10.

What High School did you attend?
11.
*

High School Graduation Year
12.
*

Transfer Student?

 (1 required)
Yes   No
13.

If yes, what school(s) did you attend?
14.

Major
15.

Extra-curricular Interest
16.

While on campus I would like to speak with
17.

While on campus I would like to stay with
18.
*

I will arrive on campus:
Thursday night by 8:00   Friday morning at 9:00

**Note**  If you are coming on an individual visit we will make time arrangements
19.
*

My parents will be accompanying me
Yes   No

* Enter Your Email Address:

Type in the text that you see above:

  
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