Student First Name

Student Middle Name

Student Last Name

Nickname (if applicable)

E-mail address

Note: An e-mail confirmation of your visit will be sent to this address.

Phone

Mailing Address

City

State
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Zip Code

Country/Province

Current High School

When do you plan to enroll?
Fall 2008 Spring 2009 Fall 2009 Spring 2010 Fall 2010

Academic Interests
Please Describe

Date of Visit
select January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , 2008
* Note: The Admissions office will be closed and/or not taking appts on these Saturday dates. The Office of Admissions offers Saturday appointments at 11:00 a.m. during the school year from January 12, 2008 through May 10, 2008.

Time of Visit
11:00 a.m.

Number of guests joining you
0 1 2 3

QUESTIONS? Contact the Office of Admissions at 1-800-MEREDITH or 919.760.8581

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