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Tour Request Registration

(* Required Fields)

Please complete the information below.  We will call or e-mail to confirm your request. If, for some reason, we cannot accomodate the date or time that you've requested, we will work to arrange an alternate date or time.

First Name*  
Last Name*  
Street Address*  
City*  
State*       Zip Code*  
Home Phone*
Email Address
Program Area(s)*  
High School
  Name*  
  Graduation Year*  

Tour Date*  
Tour Time*  
Number of guests*
(incl. yourself)
 

Campus you wish to visit* (select all that apply)

Beaver Dam  
Fond du Lac
West Bend

Please select goals for the visit (select all that apply)

Sit in on a class
Learn admission process
Discuss Financial Aid
Meet with Disability Services
Campus Tour
Take Accuplacer
Other

Requests for Special Accomodations or Other Needs