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Name (first and last)
Mailing Address
City
State: Please Select Outside US Alabama Alaska American Samoa Arizona Arkansas AF Americas AF Europe AF Pacific California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Ioiwa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Is Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming
Zip Code
Home Phone
Work Phone
Email Address
Date of Visit
Would you like to stay on campus? (space available): Select Yes No
What would you like to do during your visit: Student lead tour Meeting with academic advisor Meeting with professor Sit in on class
When do you plan to attend UAS? Semester Fall Spring Summer Year 2004 2005 2006 2007 2008 2009 2010
Will you be a: Please Select First time freshman Transfer from UA Transfer from outside UA system
What are your academic interests?
What are your interests and hobbies?
Will anyone accompany you : Please Select Yes No Not Sure
