Event Registration

First Name

Last Name

Preferred First Name

Check if address is outside of U.S. or Canada

Street Address

Apt/Suite

City

State/Province

Postal Code

Address Line 3 (Province and Postal Code)

Country

Home Phone

Student Cell Phone

Email Address

I am interested in receiving text messages from my admission counselor.

Birth Date

Parent E-mail Address

Do you have an alumni relationship?YesNo

Relationship to Alumni 1

Relationship to Alumni 2

Academic History

Foreign Language

If Yes, please list Foreign Language taken:

How many years have you taken this language?

Advanced Placement

If Yes, list which AP exams & scores.

International Baccalaureate

If Yes, list which IB exams & scores.

Dual Credit/College Courses

If Yes, what course, course number, grade received and name of college.

Do you or any of your guests have the following dietary needs?

Number of Guests (not including student)

Would you like more information on Disability Services at Jewell?YesNo

Comments, Questions, Special Accommodations?

Entry Term

Admit Type

Academic Program

Academic Level