Pacific Lutheran University

Contact Information

My E-mail Address is:

My Phone Number is:

My Name Is:
Last:
First: Middle Initial:

My Postal Address Is:

Gender:

Male Female

My birthdate is:

I currently attend this high school or college:

I Am A Prospective:
Freshman
Transfer Student
Graduate Student

My Proposed Entry Date for PLU is:
Unanswered Fall '07 Spring '08 Fall '08 Spring '09 As Soon As Possible

Date and Time

IMPORTANT: We cannot schedule your visit with out the date and time of your visit.

I will be visiting on this date:


I will be arriving at this time:

I need to leave by this time:

Including yourself, how many will attend the tour:
1 2 3 4 5 6 7 8 9 10

Interests

My Academic Interests Are:

I Am Interested In Playing The Following Sports and/or Activities:

On my visit I would like to:
(Check all that apply)
Take a tour of campus (one hour)
Visit with an admissions counselor
Sit in a class


Meet with a coach
Which coach?

Meet with a music director
In what field?

Meet with a faculty member
From which department?

Stay overnight in a residence hall
Meet with a financial aid counselor

Travel

I am coming to PLU by means of:
Car
Bus
Airplane

If you are coming by air, do you need us to make arrangements for a shuttle to pick you up?
Yes
No

If you marked yes to needing a shuttle, please include flight information with dates and time of arrival and departure below.

Emergency Contact Information

If you will be staying the night, please provide us with an emergency contact name and phone number.

Name:

Phone Number :

Additional Comments or Questions

In addition, I have the following question or comment:

Thank you for your interest in PLU!