You are registering for Duck Preview on Friday, November 8, 2019. 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 Preview 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 Preview. Text Message - None -YesNo Can we send you text messages to this phone number? Student's Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024 Student plans to enroll - None -Fall 2024Fall 2025Fall 2026Fall 2029Summer 2024Fall 2024Winter 2025Spring 2025Summer 2025 Additional guests in your party 012 Interest Session Session - None -Architecture and DesignBusinessDanceEducationHumanitiesJournalism and CommunicationMusicNatural SciencesSocial Sciences Not sure which session to choose? Explore a list of majors. 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 Leave this field blank
