Purdue University Calumet | Academic Preview Day

Academic Preview Day Registration Form

Monday, February 18, 2008
9:00 am, Student Union Library Building

First Name:
Last Name:
Address:
Address (apt.):
City:
	State: ZIP Code:
Email:
Phone:	( ) -
High School:
Graduation Year:
	I am interested in learning more about:
Number of Guests including student:

Will a parent be accompanying you? Yes No

How did you learn about this event? From my guidance councelor From a friend Received a letter Received a postcard Received an email On the Purdue Calumet web site Newspaper