• KUYPER EXPERIENCE DAY REGISTRATION

    We are looking forward to hosting you on campus!

    * Denotes required fields

    * First Name

     

    * Last Name

     

    * Address 1

     

    Address 2

     

    * City

     

    * State/Province

         

    Country

     

    * Zip/Postal Code

     

    * Phone Number

     

    * Email Address

     


     Preferred Method of Contact
    (We will send your confirmation via email)

                                                                                 

    Current High School or College

      

    Year of High School Graduation

      

    *Major of Interest

      

    *Choose a Kuyper Experience Day

      

    Are you planning on bringing
    family and/or friends?

                                             

    Name(s) of parents / guests
    who will be joining you 
     (as they would like it to appear on the name tag)   


     
    Are there any dietary restrictions we should be aware of?:    
                     
     
    If yes, please list name(s) of person(s) with dietary restriction and restriction details    
    Overnight Visit   
                     
       Overnight visit will start at 4:30 P.M. on Thursday evening. You will begin the Kuyper Experience Day at 8:30 A.M.  
       
       

    Comments/Questions/Requests

     
        

      

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