Pierre's Patio Party

Registration for Summer Patio Series

Student Information

Student's First Name*

Student's Last Name*

Birthdate*

Contact Information

Student Email Address*

Parent Email Address*

Mailing Address*

Country

Street

City

Region

Postal Code

Mobile Phone Number

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Academic Program Information

Program Level - hidden

Undergraduate

Graduate

Student Type*

Anticipated Start Term*

Academic Program of Interest*

Current School Information

Please describe your current schooling*

I attend a high school or college

I am homeschooled

Homeschool CEEB

Search for your current school (High School/College)

School CEEB

Event Information

I will be attending the reception*

Including yourself, how many guests will be attending the reception?*

Do you, or anyone in your party have any dietary restrictions or accommodations needed?

I would like to register for the Campus Tour*

Including yourself, how many guests will be joining on the campus tour?*

Please specify your restrictions or accommodation requests: