Event Information Request

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Country

Home Phone

CellPhone*

Email*

High School*

Anticipated entrance status*

First-year student Transfer student

Transferring from*

Name of school

Expected enrollment term*

Fall Winter Spring

Expected enrollment year*

Which events would you like information about?

All events Fall Visit Days Fridays at Augustana Academic Department Open House Overnight Visit Spring Preview Days It Begins with "A" Summer Academy Transfer Fridays

Optional information

Gender

Male Female

HispanicLatino

Yes No

Ethnic background

American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Pacific Islander White

Check all that apply.