Which date do you want to attend? *

Student name (first and last): *

Address: *

Phone (preferably a cell number you will bring in case of inclement weather): *

Email: *

Areas of academic interest (if know): *

Names of family members attending with you: *

Expected date of start of college (such as Fall 2013)? *

Do you want to attend the optional 2 p.m. tour? *   Yes No

If attending the 2 p.m. tour, how many people, including the student, will attend?  1 2 3 4 5 6 7 8

Provide additional information to help us plan your day (mobility, dietary):