Graduate Seminary Open House Registration

Which Open House do you plan to attend? *

June 20, 2012

First Name *

Last Name *

Preferred Name *

Gender *

Shirt Size *

Address Line 1 *

Address Line 2

City *

State *

Zip/Postal Code *

Country

Home Phone

Cell Phone

Work Phone

Undergrad Graduation Year *

I plan to Enroll:

Program of Interest:

First Choice *

Seminary

Graduate

Second Choice *

Seminary

Graduate

Guests

Guests and family members are welcome to join you for the Open House. However, please know that no childcare will be provided. In order to prepare for your guests arrival, please give us their name and relationship to you below. Please do not include fellow prospective students. Each prospective student should fill out his or her own form.

Number of Guests *

Please include the names and relationships of any guests.

Comments / Requests

Your request will be sent to the campus visit office.
If you do not receive a reply within two weeks,
please contact us at (800) 777-2227, ext. 5058.
Thanks for your interest in CIU!

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Graduate Seminary Open House Registration

Guests

Let's Impact the World Together