Oregon Private College Week: Morning Session

Student First Name

Student Preferred Name

Student Middle Name

Student Last Name

Student Birthdate

Student Email Address

Student Cell Phone

Student Home Phone

Student Home Address

Country
Street
City
Region
Postal Code

Are you a U.S. citizen or permanent resident?

Country of Citizenship

Academic Information

Applying as a:

First Year

Transfer

High school graduation year:

Anticipated college start term:

To select your current school, start typing the name of the school, then select from the drop-down list.

School you attend now

School CEEB

Are you Hispanic?

Yes

Regardless of your answer to the previous question, please select one or more of the following ethnicities that best describe you:

Are you related to an L&C alumnus or current student?

Please indicate name and graduation year of relative.

Are you related to an L&C employee?

A copy of all visit-related emails will be sent to the Parent or Guardian listed below.

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Cell

Comments

If you or anyone in your party requires special accommodations during the visit, please specify. (e.g. ADA tour route)

How did you hear about this event?

Please Note: The Office of Admissions is unable to make special appointments with Athletics, Student Support Services or Financial Aid. If you would like to meet with a member of those offices, please contact them directly.

Photo Release
By submitting this form, I authorize the Oregon Alliance of Independent Colleges and Universities, its member colleges and universities, and those acting pursuant to its authority to:

Record my child’s participation and appearance in “Oregon Private College Week” on videotape or audiotape, in photographs, or in any other recorded medium. I understand that these recordings may be used in any medium, including print, Web, video, or audio.
Use my child’s name, likeness, voice, and biographical material in connection with recordings.
Exhibit or distribute such recording in whole or part without restrictions or limitation for any educational or promotional purpose, which the Oregon Alliance of Independent Colleges and Universities, its member colleges and universities and those pursuant to its authority, deem appropriate.

I waive any right I might have to inspect and/or approve the finished medium, or the use to which it may be applied.

I represent that I am at least 18 years of age and that I have read and fully understood the above paragraph and am knowingly and voluntarily executing this release without compensation to myself.