Inquiry Form

STUDENT INFORMATION

If you are completing this form on behalf of a student, please provide the student's information below.

First Name

Preferred First Name (Optional)

Last Name

Birthdate

Personal Pronouns (Optional)

He/Him/His

She/Her/Hers

They/Them/Theirs

Other

If other, please describe.

STUDENT CONTACT INFORMATION

Email Address

Cell Phone

Mailing Address

Country

Street

City

Region

Postal Code

PARENT INFORMATION

Would you like to provide parent / guardian information?

Yes

No

Parent / Guardian 1

Relationship Type

First Name

Last Name

Email

Phone Number

Parent / Guardian 2 (Optional)

Relationship Type

First Name

Last Name

Email

Phone Number

EDUCATION INFORMATION

Expected Term of Entry

Student Type

New Freshman

Transfer

Area of Academic Interest

Secondary Education Area of Study

Current or Most Recent High School (Select from drop-down list.)

CEEB Code

Current or Most Recent College/University (Select from drop-down list.)

CEEB Code

Comments or Special Requests (Optional)