First Name

Last Name

Phone (XXX)XXX-XXXX

Email

High School Grad Year

How many people (including you) will be attending with you?

What is your intended major? *Undecided Accounting Applied Ministry Associate in General Studies Associate of Arts Associate of Arts in Criminal Justice Associate of Science in Health Science Biology Chemistry Communication Criminal Justice Elementary Education English Entrepreneurship Exercise Science Fitness and Recreational Leadership General Studies Health & Human Services Health Science History Liberal Studies Liberal Studies - Pre-Law Management Marketing Mathematics (pre-engineering) Music Natural Science Organizational Leadership Pastoral Ministry Physical Education Psychology Risk Management Secondary Education - Mathematics Sport Management Student Ministry Worship Arts

Gender

Address One

City

State

Zip

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