Information Request Form

I am interested in a...

Select the option below that best describes you:

Current or Most Recent School

Graduation Date:

Please select the program below that most interests you:

Are there any other programs you are interested in as well? If so, please list:

Please choose a preferred campus/location:

Please select the program below that most interests you:

Do you plan to take undergraduate level courses or graduate level courses?

What year are you planning to start school?

What semester are you interested in?

Fall

Spring

Student Contact Information

Student Legal First Name

Preferred Name/Nickname

Student Legal Last Name

Birthdate

Email Address

Mobile Phone Number

May we text you?

Yes

Current Mailing Address

Country
Street
City
Region
Postal Code

Please select your country of citizenship:

Are you a Permanent Resident?

Yes

Please select your current Visa status OR the Visa you intend to pursue:

Questions/Comments:

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Are you interested in trying out for our Esports Team?

Preferred Game

Rank

Battle.net ID / Summoner Name

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