Student Name

First Name (Given Name)

Last Name (Surname)

Preferred Name

If you go by a name other than your legal first name and you'd prefer that we call you by that name, enter that name above. (Example: Your name is William, but you prefer to be called Bill.)

Student Contact Information

Email Address

Country

Country Code

Address

City

State

State Code

ZIP/Postal Code

Cell Phone

Home Phone

Academic Information

What term do you plan to start?

Academic Term ID

What type of student will you be?

What is your intended major?

Learning Program ID

Visit Information

When would you like to visit?

Visit ID

How many guests (including student)?

Would you like to visit with a professor? (Weekdays only - based on office hours)

If you have a documented learning disability, would you like to visit with the Jones Learning Center? (available on weekdays)

Are you interested in visiting with a coach? (available on weekdays)

Do you have an accessibility need?

Please briefly describe your accessibility needs.