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DU FALL EVENT REGISTRATION FORM
Event Location: Dillard University, PSB
Event Date(s): Friday, November 10th & Saturday, November 11th
Event Time: 8:00am Check-In on Friday, November 10th and 9:30am Check-In on Saturday, November 11th
Event Participants: Friday, November 10th is open to high school seniors.
Saturday, November 11th is open to all prospective students.
First Name (Example: Marcus)
Your answer
Last Name (Example: Jackson-Smith)
Your answer
DU ID# (If applicable)
Your answer
Mailing Address (Example: 25 Cole St. Apt 8)
Your answer
City (Example: Little Rock)
Your answer
State (Example: AR)
Your answer
Zip Code (Example: 71234)
Your answer
Email (Example: myemail@email.com)
Your answer
Primary/Cell Number (Example: 504-816-4670)
Your answer
Would you like to receive text messages from us?
Current School Name (Example: KIPP Sunnyside)
Your answer
Current Grade Level
Academic Area of Interest
Which event will you attend?
Required
I understand that I will have to pay $$ for event tickets
Captionless Image
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Thank you for registering to attend one of our upcoming events. We look forward to seeing you soon!
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