Register For Kansas Private College Week 2008

Please complete the following form to register for KPCW 2008. If you have any questions please call 1-877-462-5729 or email Mark Millikan. **NOTE: Transportation is not provided. Travel arrangements are the responsibilites of the registrants and/or their guests.

  Student Information * Denotes Required field
  * First Name:   * Last Name:
  * Address: Phone: ex. xxx-xxx-xxxx
  * City:   * State:    * Zip Code:  
  * Email: * Retype Email:    
  *High School:   * Year of Graduation:
 
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.
  Monday, June 2nd
College Selection
Number Attending
Guest(s) Name and their relationship to you
  9:00 AM *
  1:30 PM *
 Tuesday, June 3rd
College Selection
Number Attending
Guest(s) Name and their relationship to you
  9:00 AM *
  1:30 PM *
  Wednesday, June 4th
College Selection
Number Attending
Guest(s) Name and their relationship to you
  9:00 AM *
  1:30 PM *
  Thursday, June 5th
College Selection
Number Attending
Guest(s) Name and their relationship to you
  9:00 AM *
  1:30 PM *
  Friday, June 6th
College Selection
Number Attending
Guest(s) Name and their relationship to you
  9:00 AM *
  1:30 PM *
 
  Academic Area of Interest/Major:
  
 
  Extra-Curricular Interests:
  
 
  How did you hear about KPCW?
 
  Do you have any special needs? For example: accessibility, diet, etc.
  
 
    
 
       
Kansas Independent College Association | 700 S. Kansas Ave, Suite 515 | Topeka, KS 66603-3889