Harrisburg University Dual Admissions Intent Form

* indicates a required field

Student First Name *

Student Preferred Name (if different than your first name)

Student Last Name *

Email Address *

Birthdate *

Mobile Phone Number *

May we text you? *

Yes

No

Please select your primary country of citizenship *

Most Recent College/University Attended *

Please select your current academic program *

Please select the Harrisburg University program that interests you *

Anticipated Year to Start *

Starting Semester *

Candidate Type (hidden)

Candidate Location (hidden)

By submitting this form, you agree that Harrisburg University is authorized to share your information with HACC to verify your transfer eligibility.