Weekday Campus Visit Registration - Admissions Office

University of Wisconsin - Stout

First Name:

Last Name:

Address:

City:

State:

Zip Code:

Area Code and Phone Number

Day:

Night:

E-mail address:

Birth Date (mm/yy):

Name of High School:

Graduation Date (mm/yy):

I will be a:

Freshman

Transfer

What degree program are you interested in?

Program:

Date you plan to visit:

Date:

Arrival Time

9:00 a.m.

11:00 a.m.

1:00 p.m.

2:00 p.m.