You are registering for Duck Days on Friday, April 5, 2019. You must be admitted to the UO in order to complete the form and attend the event. Student InformationIf you are a parent or guardian, please fill our your student's information here. You will have a chance to enter your contact information on the next page of this form. Student's First Name * Student's Preferred First Name Fill out this field if you go by a preferred name or nickname that is different than the name listed above, otherwise leave this field blank. It will be featured on your Duck Days communications and name tag. Student's Last Name * Student's Email Address * Student's Phone Number * A phone number where we can notify you of any changes to Duck Days. Text Message - None -YesNo Can we send you text messages to this phone number? Student's Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19191920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019 UO ID * Your University of Oregon ID number is 9-digits and begins with "95." We provided your UO ID in a letter when you applied for admission. Can't find it? Call 541-346-1274 for help. Additional guests in your party 012 Mailing Address Address * Address Line 2 City * State * AlaskaAlabamaArmed Forces AmericasArmed Forces EuropeArmed Forces PacificArkansasAmerican SamoaArizonaCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaGuamHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMaineMassachusettsMarylandMarshall IslandsMichiganMicronesiaMinnesotaMissouriMariana IslandsMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUS Virgin IslandsUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyomingXX ZIP Code * Special accommodations / Interpretation needed
