Admission: Campus Visit Registration Form

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Register for your visit to Jewell!

Please fill out the form below. All fields marked with a red asterisk (*) are required. When you have finished, please click the "I'm coming to visit Jewell!" button.

*Choose your visit type:
*Individual Visit Date:	(Only if selected above)
*First Name
*Preferred First Name/Nickname
Middle Initial
*Last Name

*Street Address
*City
*State
*Zip Code

*E-mail
Phone Number (xxx-xxx-xxxx)
Cell Phone Number (xxx-xxx-xxxx)	Please check if you accept text messages

Gender	Female Male

*High School
City and State of High School
*Year of High School Graduation
Anticipated College Start Term


Academic Programs of Interest:
First major
Optional second major
Optional minors
Pre-Professional Programs


Student Clubs & Organizations (use the control [Ctrl] key to select multiple options)
NCAA Division II Athletics (use the control [Ctrl] key to select multiple options)
Comments? Questions?



Note: After submitting this form, the Office of Admission will contact you via phone and/or email to confirm your visit to campus. If you have questions, please contact the Admission Office at 816-415-7511.

500 College Hill - Liberty, MO 64068
816.781.7700

Office of Admission: 1-888-2-JEWELL