Tell Us About Yourself

Personal Information

First Name

Preferred Name

Last Name

Mailing Address

Country

Street

City

Region

Postal Code

Gender

Pronouns

Birthdate

Email Address

Mobile Phone

Academic Information

Student Type

Entry Term

Anticipated Major

Anticipated Pre-Professional Program

Citizenship

Are you Hispanic or Latinx?

Yes

Regardless of your response to the previous question, please select all races that apply

High School

High School Graduation Date

College

Level of Study

Are you a 21st Century Scholar? (Indiana Residents Only)

Yes

Extra Curricular Interests

Do you want to play Division III Athletics?

Yes

Select which sport you would like to participate in.

Position

Parent Information

Would you like to provide parent information?

Yes

Relationship Type

Parent First Name

Parent Last Name

Parent Email

Parent Phone

Would you like to provide other parent information?

Yes

Relationship Type

Parent First Name

Parent Last Name

Parent Email

Parent Phone