E-Sports Request for Information Form

I am a prospective... *

First-year

Transfer

Are you an international student?

Yes

No

Desired start term

First Name

Last Name

Birthdate

Email

Please communicate with my parent, as well.

Mailing Address

Country

Street

City

Region

Postal Code

Mobile

Parent Information

Parent/Guardian Type

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone

Academic History

Current or most recent high school (start typing to select school)

High school graduation year

Current or most recent college (start typing to select school)

Educational Information

Primary academic interest

Secondary academic interest

Anything else you would like to let us know? Comments? Questions?

By submitting this form, I agree to phone calls and/or text messages from or on behalf of Fort Lewis College at the phone number provided on this form, including my cell phone number. I understand that these calls may be generated using automated technology. I further understand that I can opt-out of these communications by emailing UNSUBSCRIBE to admission@fortlewis.edu.