Student First Name * Student Last Name * Preferred Pronouns * Birth Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020 E-mail Address * This will be our primary method of communication with you. Cell Phone Number * We will only use this if we need to contact you on your visit day or if we have trouble contacting you via email. What is your planned major? * It's OK if you don't know for sure - just give us a general idea of your academic interests. Pre-Professional Track? (ie, Pre-Med, Pre-Dent, etc.) Permanent Address (Home) Address * City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip * High School Current Class Year * - Select - High School Junior High School SeniorOther (please specify below) Other Have you been accepted to Temple University? * - Select -YesNo Have you visited Temple University before? * - Select -YesNo Will you bring anyone with you on your visit day? If so, who? If you choose to bring guests with you, they're welcome to attend any portion of the visit day you'd like except attending a class (due to space issues). Please note that minors must be accompanied by an adult/legal guardian. 1st Choice Visit Date * - Select - 4/4 4/9 4/11 4/16 4/18 4/20 4/23 4/25 4/27 2nd Choice Visit Date * - Select - 4/4 4/9 4/11 4/16 4/18 4/20 4/23 4/25 4/27 What would you like to do while you're here? General Temple Information Session and Campus Tour (Please let us know if you have already registered for a tour through Admissions. If not, we are happy to do so for you!) Tour 1300 Residence Hall (including the Honors Living Learning Community) Shadow an Honors Student to an Honors Class Chat with Current Honors Students Meet Fox Business Honors staff and tour facilities (only available for accepted Fox Honors students) All visits already include a meeting with Honors Program staff. Other (elements you want on your visit, time constraints, etc.) Is there anything else you think we should know about you in order to match you with similar current students? (i.e. Are you vegan? Do you play the tuba?) Leave this field blank CAPTCHAThis question is for testing whether you are a human visitor and to prevent automated spam submissions. Math question * 5 + 14 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.