Scholar Symposium Day

Personal Information

Student First Name

Student Preferred First Name
(this will be printed on your name tag)

Student Last Name

Birthdate

Contact Information

Mailing Address

Country

Street

City

Region

Postal Code

Student Email Address:

Student Mobile Phone number:

I'd like to receive texts from Allegheny:

By submitting this consent, you are providing your express
written consent that Allegheny College may, directly or through third-parties
acting on its behalf, send marketing information regarding Allegheny and
your continuing education, including texts, e-mail, and calls made using an automated
dialing system to the number and email address that you provided above. Providing
this consent is not required to obtain any good or service.

Yes

Allegheny College Privacy & Security Statement for Submission of Information via the Web

Academic Information

High School Name

I am a...

College or University Name

When do you plan to enroll?

Additional Information

What academic programs at Allegheny College interest you?
*Indicates programs are only available as minors.

First Academic Interest

Second Academic Interest

Pre-Professional
Indicate your interest in pursuing a pre-professional pathway or an accelerated or dual degree program with on of Allegheny's school partners:

Would you like to provide your parent's information?

Yes

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email Address (will receive copy of the event registration)

Please choose one:

Guest Information

Number of guests, including you, visiting:

Name of Guest(s):

Are any of your guests Allegheny alumni?

Yes

Additional Comments