Request for Information

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Personal Information

First Name*

Middle Name

Last Name*

Preferred First Name

Birthdate*

Gender*

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Contact Information

Email Address*

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Mobile Phone Number*

Alternate Phone Number

May the Admissions Office contact you via text?

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Address*

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School Information

Enter the high school or college you currently attend or most recently attended. (If you are homeschooled, please indicate "homeschool.") *

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Academic Interest

I am considering ETBU as a:*

Intended entry term:*

My primary academic interest is:

Extracurricular Interests:

Additional Information

How did you hear about ETBU?*

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What is your current level of interest in ETBU?*

Additional comments or questions: