Student Information Request

Student Information

Name*

First Name

Middle Name

Last Name

Current Mailing Address:*

Address Line 1

Address Line 2

City

State

ZIP Code

Date of Birth:*

Email:

Mobile Phone:

Please include as much as possible so that we may ensure to provide the best information.

ACT/SAT Score:

College Major Preference:

Term you plan to enroll:

Year you plan to attend:

High School Diploma:

GED:

Check all that apply:

Athletics

Football Basketball Baseball Softball Cheerleading Check All

Fine Arts

Band Chorus Tiger Dancer Theatre Check All

Campus Country

Vocalist Instrumentalist Sound/Technical Check All

Would you like a Campus Tour:

Any additional comments or questions?