Yes! I'd like to visit Defiance College!


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I would like to visit campus on:
1st Date:   Number Attending:

Choose your own date      
Number Attending:

PERSONAL INFORMATION

Defiance College admits students regardless of race, color, religion, gender, age, national and ethnic origin, disability, or sexual orientation.

First Name   Middle Name
Last Name   Preferred Name
Maiden Name      
         
Mailing Address
City State Zip/Postal Code
County Country  
           
Home telephone     My Email  
Alternate phone     Parent's Email  
Cell phone          
Date of Birth          
Are you a US citizen?   Y   N   If no, Country of Citizenship  
            Are you a permanent resident?  
Y   N
Gender   Female   Male    
                 
Ethnic Origin
Are you Hispanic/Latino?   Y N  

Are you from one or more of the following racial groups:
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White


ACADEMIC INFORMATION
Please list all high schools, colleges, or universities you have attended, beginning with the most recent:
Date of Graduation Name City State Dates Attended Degree
Self-reported G.P.A.
Self-reported ACT composite score Essay Score
Self-reported SAT composite score
SAT critical reading math writing

AREAS OF INTEREST
I am interested in the following degree program(s):
Bachelor of Arts (BA)   Master of Arts in Education (MAE)
Bachelor of Science (BS)   Master of Business Administration (MBA)
 
During my visit I would like to: (please check)
Speak with an Admissions/Financial Aid Counselor
Talk with a Coach (list sport)
Talk with a faculty member in my major
Sit in on a class in my major
Tour Campus
Speak to someone about my activities (listed below, check all that apply

Collegiate Activities
In which activities do you plan to participate in college?
American Marketing Assn. Yearbook Black Action Student Assn.
Religious Activities Ecology Club Criminal Justice Society
Community Service Student Senate Campus Activities Board
Fraternities or Sororities  Newspaper Student in Free Enterprise
Vocal/Choral Music GLASS Social Work Assn.
Pep Band    

Intercollegiate Activities
In which intercollegiate activities do you plan to participate?
Baseball Basketball Track
Softball Cheerleading Football
Volleyball Soccer Tennis
Cross-Country Golf Swimming and Diving
Lacrosse    
 
Major Preference:
Choice #1
Choice #2
   

If an education major was selected above, choose a teaching field or a licensure.
 

TELL US MORE ABOUT YOURSELF (optional)

SEND ME SCHOLARSHIP INFORMATION
Scholarship Day Information
Service Leadership Award Information
 
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