Wayland University Preview Weekend

Academic Day Online Registration Form

* First Name:	*Required
* Last Name:	*Required
Gender:
* Address:	*Required
* City:	*Required
* State:	*Required
Zip:
* Phone Number:	*Required
Cell Phone Number:
* Email Address:	*Required
High School:
* High School Graduation Year:	*Required
Intended Major or Interest:
Athletic Interests:
Other Interests:
Sign-Up Date:
Academic Days Session Preferred	*Required