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Information Request
UWM Preview Days
* I am interested in attending the following date:
--Select--
December 11 2009
February 8 2010
March 5 2010
April 9 2010
May 7 2010
First Name:
Middle Initial:
Last Name:
* Date of Birth:
(01/01/2007)
* Gender:
--Select--
Male
Female
* Street Address:
* Address line 2:
* City:
* State:
--Select--
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* Zip:
* Phone:
(123-456-7890)
* E-mail:
High School Attending:
* Graduation Year:
* Intended Major at UWM:
* Total number of guests attending:
Not including the student
Tour preference:
8:40 early bird tour
12:30 afternoon tour
11:15 event choice:
Honors College Info Session
Financial Aid Workshop
note: this will help us better determine space needs
11:45 event choice:
Student Panel
Financial Aid Workshop
note: this will help us better determine space needs
* Special accommodations needed?:
Yes
No
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
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Puerto Rican
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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