Take a Grad to Class Registration Form

Please fill out the form below, and hit the submit button.
( * denotes a required field ).


Contact Information

First Name: *

Maiden Name:

Last Name: *

Email: *

Address: *

City:*

State (XX): *

Zip (99999): *

Home Phone Number (999-999-9999): *

Cell Phone Number (999-999-9999):

Graduation Year (9999): *

School Information

Major: *

Minor:

Which professors made the biggest impact on you while you were a student?: *

Please check the boxes that you are available: *
Class 1 9:00am – 9:50am
Class 2 10:00am – 10:50am
Class 3 11:00am – 11:50am
Lunch – Noon

Would you be interested in a campus tour?: *
YES
NO