School of Individualized Study Graduate Open House

Student Information

Student First (Given) Name

Do you want to add a student preferred name?

Yes

No

Student Preferred First Name (if different)

Student Last (Family) Name

Student Birthdate

Primary Country of Citizenship

Student Email Address

Student Mobile Phone

Supplying your mobile phone number will opt you into receiving periodic text messages related to the enrollment process and important deadlines. Message rates may apply.

Student Address

Country

Street

City

Region

Postal Code

Academic Information

Campus (HIDDEN FIELD - DEFAULT to MAIN)

HIDDEN: Student Type

Intended Term of Entry

Do you want to pursue your graduate study on a full-time or part-time basis?

Do you intend to pursue your graduate study on campus or online?

Intended Online Program

Intended Program

HIDDEN: 1st Choice (Major Grad) - combines the 2 unique 1st choice major fields for online and campus and saves in the official system field

HIDDEN: Assign 1st Choice Intended Major Prompt GUID to GRAD 1st Choice Intended Major Acad Dataset Related Dataset Row

College Name/Last School Attended

CEEB Code (Will populate if school is selected from the list)

Are you eligible to receive military benefits from the United States Department of Veteran Affairs (VA) as a veteran, service member, dependent or spouse?

Will you be using educational benefits from your employer to help pay for your graduate study?

Event Registration Information

Will you have a guest joining you? (one additional guest permitted)

Guest name

Would you like us to arrange for a sign language interpreter for your visit?

Yes

No

Anything else you'd like us to arrange for your visit or topics/questions you'd like addressed?

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