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Event Information Request

Student's Name:
First Name:
Last Name:
Address:
Street Address:
City:
State:
Zip:
Country:
Home Phone:
Cell Phone:
Email Address:
High School Information:
High School name:
High School city:
Anticipated entrance status:
First-Year Student
Transfer student from:
Expected date of enrollment:
Fall Term Winter Term Spring Term
2015 2016 2017 2018
Which event would you like information about?
All events
Visit Days
 Fridays at Augustana
Academic Department Open House
 Overnight visit
 Spring Preview Days
 It Begins with "A"
Augustana Summer Academy
Transfer Fridays — transfer visit days
Optional Information
Gender: Male Female
Are you Hispanic/Latino? Yes No
Ethnic Background (check all that apply):
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White