Virtual Open House

Saturday, April 17, 2021 at 10:00 AM until 3:00 PMEastern Daylight Time

Interaction Code - UG (Hidden)

Student Biographical Information

Student Given First Name

Student Preferred First Name (if different)

*If a preferred name is provided, we will use it in all communications including physical mailings to your mailing address.

Student Last Name

Student Date of Birth

Student Contact Information

Student Email Address

Student Mobile Phone Number (please include area code)

*By providing your mobile phone number, you agree to receive text messages from Elizabethtown College.

Student Mailing Address

Country

Street

City

Region

Postal Code

Student Academic Information

Student Type

Intended Entry Term

Primary Academic Interest

Secondary Academic Interest (if applicable)

Current school you are attending (if you are not currently enrolled anywhere, please enter the most recent institution you attended

Would you like to provide us with your parent or guardian's contact info?

Yes

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Relation to Student

Parent/Guardian Email Address

Parent/Guardian Phone Number (please include area code)