Student Contact Information

First Name

Please provide the student's full legal first name, for example what the student would use on an SAT/ACT test registration. This helps us better match information we are receiving from multiple sources.

Middle Name

Last Name

Preferred Name

We will use this name to address you in emails and letters.

It is best to use a unique email address for every student rather than a family email address to prevent students information from becoming confused.

Street Address

City

State or Territory

Country

Zip/Postal Code

Sex

School Attending

When searching for schools, if the name contains the word Saint please use St

Program Information

Student Type/Admissions Category

Anticipated Freshman Start Term

Anticipated Transfer Start Term

Anticipated Start Year

Please Note: (m) indicates a Minor only and (p) indicates a Pre-Professional program only.

Academic Interest

Academic Interest #2

Academic Interest #3

Optional Information

Birthdate (mm/dd/yyyy)

Home Phone

Mobile Phone

Your mobile phone may be used for text messaging

Opt Out

Are you Hispanic?

YesNo

Regardless of your answer to the prior question please indicate how you identify yourself.
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