| Student Information |
* Denotes
Required field |
| * First Name:
* Last Name: |
| * Address:
Phone:
ex. xxx-xxx-xxxx |
| * City:
* State:
* Zip Code:
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| * Email:
* Retype Email:
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| *High School:
* Year of
Graduation:
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Student Itinerary
When creating an itinerary, the College Selection field is a required field for each date and time. If you do not wish to visit a particular college or university on that day and time, simply choose None from the College Selection drop down menu. The fields for Number Attending and Guests are not required but does help each college prepare for your campus visit. |
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Monday, June 2nd |
College Selection |
Number
Attending |
Guest(s) Name and their relationship to you |
| 9:00 AM |
*
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| 1:30 PM |
*
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| Tuesday, June 3rd |
College Selection |
Number
Attending |
Guest(s) Name and their relationship to you |
| 9:00 AM |
*
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|
| 1:30 PM |
*
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Wednesday, June 4th |
College Selection |
Number
Attending |
Guest(s) Name and their relationship to you |
| 9:00 AM |
*
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| 1:30 PM |
*
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| Thursday, June 5th |
College Selection |
Number
Attending |
Guest(s) Name and their relationship to you |
| 9:00 AM |
*
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|
| 1:30 PM |
*
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| Friday, June 6th |
College Selection |
Number
Attending |
Guest(s) Name and their relationship to you |
| 9:00 AM |
*
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| 1:30 PM |
*
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| Academic Area of Interest/Major: |
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| Extra-Curricular Interests: |
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| How did you hear about KPCW?
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| Do you have any special needs? For example: accessibility, diet, etc. |
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Kansas Independent College Association | 700 S. Kansas Ave, Suite 515 | Topeka, KS 66603-3889 |
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