From www.taylor.edu - Taylor University, integrating faith and learning

Information Request Form (Student)

* Indicates Required Field
 
Personal Information
 
*Student First Name
*Student Last Name
 
Preferred Name
 
*Gender
 
*Address Line 1
 
Address Line 2
*City
*State
 
 
Zip Code
 
Country
 
*Phone
example: (555) 555-5555
*E-mail
Note: A copy of this form will be emailed to this address upon completion.
Send me this email as HTML instead of plain text.
*Birthdatemm/dd/yyyy
 Calendar
 
Parent Information

We may send information to your parent(s). Please list the first and last name of the parent(s) that you live with.

 
 
Father's Full Name
 
Mother's Full Name
 

Academic Information

 
 
Proposed Major
*High School
*H.S. City
*Expected High School
Graduation Date		mm/dd/yyyy
 Calendar
 
GPA
 
On a
 Scale
 
*Transfer Student
 
Other Information
 
 
I am interested in participating in the following sport:
 
 
 
I am interested in participating in the music department (if vocal, indicate part, if instrumental, indicate which instrument)
 
 
 
What prompted you to visit our website? Select all that apply.
 
 
If "Other"
 
 
How did you first hear about Taylor?
 
 
If "Other"
 
 
Additional Comments/Requests