Oxley College of Health and Natural Sciences Day

Fields marked with an * are required.

First/Given Name *

Last Name *

Preferred First Name

Birthdate *

Mailing Address *

Country

Street

City

Region

Postal Code

Mobile Phone number *

Student Email Address *

Email Address to be used for visit confirmation if different than above

Which of the following best describes your student type? *

Incoming First-Year Student (have not yet graduated from high school or have not taken any college courses since high school graduation)

Transfer (have taken at least one college course since graduating high school)

Non-Degree Seeking student (only wish to take a couple of courses)

What is your anticipated entry term? *

Academic Interests (select all that apply)

High School *

College Attended *

How many guests will be attending with the student?

0

1

2

Is Guest #1 a parent or guardian?

Yes

No

Guest #1 Relationship to You*

Guest #1 First Name*

Guest #1 Last Name*

Guest #1 Email*

Is Guest #2 a parent or guardian?

Yes

No

Guest #2 Relationship to You*

Guest #2 First Name*

Guest #2 Last Name*

Guest #2 Email Address*

Do you have any special dietary requests?

Yes

No

Dietary Requests (hold SHIFT key to select more than one option)

Do you need special assistance around campus?

Yes

No

What type of assistance is needed?