First Name:

Preferred name:

Last Name:

Street Address

City:

State:

Zip Code:

Cell Phone

Email Address

Which semester do you intend to enroll?

Academic Program of Interest.

Are you a first-year student entering directly from high school, or a transfer student?

High School Name:

Year of High School Graduation

Previous College(s) Name(s)

Class attendance is for students only. If you will be bringing guests, how many will attend the admissions session and lunch?

Do you or your guests have any accommodation or support needs? Select all that apply:

Language assistanceAccessibility accommodationsFood allergies or dietary restrictionsOther

Please specify allergies or dietary restrictions:

Please specify other accommodation or support needs:

How did you hear about this event?