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Experience Augustana Registration

March 30-31

* indicates a required field

First Name: *
Preferred Name:
Last Name: *
Address: *
City: *
State: *
ZIP: *
Home Phone: *
Cell Phone:
Emergency Contact: *
Relation of Emergency Contact: *
Phone Number for Emergency Contact: *

A valid e-mail address is required to receive your confirmation for the event.

Email: *
Parent Email:

Intended major (s):

I would like to arrange:

meeting with a coach (Sport: )

meeting with a faculty member (Department: )

meeting with fine arts (Specialty: )

Campus Tour: *
Full campus tour
Residence hall tour only
Academic hall tour only
No tour

Please list names of the people that will be joining you, and your relationship with them:

Parents, will you be attending?:

The parent reception (total number of guests: )

The parent lunch (total number of guests: )