UW-Milwaukee: Info Nights Registration

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Info Nights Registration

Please select the location of the Info Night you wish to attend from the list below, and fill out the remainder of the form.

Additional Information
Check in will begin at 6:30 pm. Light refreshments will be served and information browse tables will be available during that time. The program will start at 7:00 pm and will wrap up around 8:00pm.

We look forward to seeing you at Info Nights!

Info Night Date and Location:

First Name:

Middle Initial:

Last Name:

* Gender:

Date of Birth:

(01/01/2007)

Address:

City:

State:

Zip Code:

Home Phone:

(123-456-7890)

E-mail Address:

Number Attending:

(including student)

Academic Area of Interest:

Current High School:

Year in High School:

If Senior, please select one:

Please indicate special accommodations:

(i.e. wheelchair accessibility, interpreter, etc.)

Race / Ethnicity:

African-American or Black

American Indian or Alaskan Native (please specify tribal affiliation below)

Hawaiian or Pacific Islander

Cambodian

Hmong

Laotian

Vietnamese

Other Asian

Mexican or Mexican American or Chicano

Puerto Rican

Cuban

Other Hispanic or Latino

White or Caucasian

Other (please specify below)

I choose not to respond

tribal affiliation / other ethnicity:

If you checked off American Indian or Alaskan Native or Other above, please specify here

University of Wisconsin-Milwaukee
P.O. Box 413, 2200 E. Kenwood Blvd.
Milwaukee, WI 53201-0413
(414) 229-1122

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