Mailing Address

Apartment #

City

State

Zip Code

E-Mail

Phone Number

Please indicate if you are a prospective first time freshman  or transfer student

Are you a Military Veteran?   Yes No

Intended College Major

Name of college(s)/high school currently attending (specify campus)

How many guests will be attending the Open House?

Are you interested in a tour? Yes No

Referred by: UHD Website UHD Postcard UHD Poster UHD Faculty UHD Staff UHD Student High School Counselor College Counselor College Fair Other if other please specify