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Enrollment Deposit Form

- All fields are required -

PLEASE NOTE: Enrollment deposits are non-refundable.

Student Name:

First:

Middle:

Last:

 

Address:

Street

City:

 

State: Zipcode:

Phone:  Phone Type:
Cell phone primary user:
Email address:
Email primary user:
Entry Year / Type:    Freshman Transfer Fall Spring
Housing: Do you plan to live in campus housing? Yes  No
Major:

 (first choice)

 (second choice)

Please enter the red letter from the following image: (Required)

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