Daily Visit - Saturday

Student Contact Information

Student First Name

Preferred Student First Name

Last Name

Personal Email Address

Mobile Phone Number (SMS Text Event Reminders)

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Parent / Guardian Contact Information

First Name

Last Name

Phone

Email Address

Contact Type

Please indicate this contact's relation to you

Student Academic Information

College Start Term

Major of Interest

We encourage you to contact academic departments or coaches directly if you are looking to connect with them when you visit campus. Follow the link on the next page to find contact information.

Intended Level of Study

Most Recent High School

Year of High School Graduation

Special Accommodations

Wheelchair

Spanish Translator

Hmong Translator

High School Lvl of Study -- Hidden Field

High School Ceeb -- Hidden Field

Campus Preference - Hidden Field

Relationship 2 First -- Hidden (Set Parent entered as Emergency Contact)

Relationship 2 Last -- Hidden (Set Parent entered as Emergency Contact)

Relationship 2 Phone -- Hidden (Set Parent entered as Emergency Contact)

Relationship 2 Email -- Hidden (Set Parent entered as Emergency Contact)

Relationship 2 Type -- Hidden (Set Parent entered as Emergency Contact)