Yes! I'd like to visit Defiance College!


Please note when filling out this form: Use the Tab Key to switch from question to question, or use your mouse. Hitting the Enter Key will submit the form.

Choose your own date:   

Summer Visit Schedule (May - August): Monday - Friday, 8:00 am - 2:00 pm
**Please note: Campus visits are not available on Saturdays during the summer
or the following dates for summer 2015: June 12, 19, 26
July 3
August 10
September 5

Number Attending:


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
Black or African American
Native Hawaiian or Other Pacific Islander

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

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 Wrestling (club)
Major Preference:
Choice #1
Choice #2

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


Scholarship Day Information
Service Leadership Award Information