LATE ORIENTATION REGISTRATION

COMPLETE THIS ONLINE FORM AND PAY BY CREDIT CARD. PLEASE COMPLETE ONE FORM FOR EACH STUDENT ATTENDING. THERE IS A $10 CHARGE FOR THE STUDENT; $10 CHARGE PER GUEST.

First Name* 

Middle Initial 

Preferred first name* 

Last Name* 

Address * 

City * 

State* 

Zip* 

Phone* 

Email* 

Major/Pre-professional Program* 

birthdate* 
Date Picker
Please list the names of your guests (if any) who will be attending.
Guest Name 

Guest Name 

Guest Name 

Number of guests (do NOT include student)* 

Total 

Special Needs: If you or a guest is disabled or have special needs, please tell us how we can help you during your Orientation Session.