Request for Information

*Last Name:

*First Name:

Middle Name:

Street Address:

Street Address Line2:

City:

State/Province:

Zip Code:

Phone with Area Code:

email:

What semester do you want to begin? Fall 2009 Spring 2010 Fall 2010 Spring 2011 Fall 2011 Spring 2012

Cell Phone:

Birth Date
(mm/dd/yyyy): 

Parent Information

Father's name:

Occupation:

Mother's name:

Occupation:

High School:

Graduation Year:
Class Rank:

Grade point average:
ACT score:

High School Coach:

Coach Email:

Coach Phone Number:

Which sports are you interested in:
Golf
Tennis
Track and Field
Swimming and Diving
Men's Hockey

What is your level of interest in UWRF?

Strong Average Slight

Ethnic Background

Academic Interest:

Undecided Accounting Agriculture - Broad Area Agricultural Business Agricultural Economics Agricultural Education Ag Engineering Technology Agronomy Animal Science Anthropology Art Biology Biotechnology - Ag Emphasis Biotechnology - Liberal Arts Emphasis Business Administration Chemistry - Liberal Arts Chemistry - Biochemistry Emphasis Chemistry - Polymer Emphasis Communicative Disorders Computer Systems - Computer Science Computer Systems - Information Systems Conservation - Natural Resource Mgt Conservation - Environmental Analysis Early Childhood Education Economics Elementary Education English Food Science and Technology Geology Geography Health and Human Performance History Horticulture Journalism - News Editing Journalism - TV and Radio Broadcasting Land Use Planning Marketing Communications Mathematics Modern Language - French Modern Language - German Modern Language - Spanish Music Physics Political Science Pre-Engineering Pre-Law Pre-Medicine Pre-Optometry Pre-Pharmacy Pre-Veterinary Medicine Psychology Science Broad Field Secondary Education 22 content areas Social Studies Broad Field Sociology Social Work Soil Science Speech Communication

If transfering, from what school?

Have you applied to UWRF?

Yes No

Have you been accepted at UWRF?

Yes No

Athletic Honors, Awards, Stats:

If you have specific questions or additional requests, please use the box below: