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Experience Augustana Registration

First Name:
Preferred Name:
Last Name:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Emergency Contact:
Relation of Emergency Contact:
Phone Number for Emergency Contact:

A valid e-mail address is required to receive your confirmation for the event.

Email:
Parent Email:

Choose a date:

Intended major (s):

I would like to arrange:

meeting with a coach (Sport: )

meeting with a faculty member (Department: )

meeting with fine arts (Specialty: )

Campus Tour:

Please list names of the people that will be joining you, and your relationship with them:

Parents, will you be attending:

The parent reception (total number of guests: )

The parent lunch (total number of guests: )