Trevecca Nazarene University

*First Name:

Middle Initial:

*Last Name:

*Address 1:

Address 2:

*City:

*State:

*Zip:

*Home Phone:

Cell Phone:

*Email (only one):

*Confirm Email:

Parent/Guardian Name (First and Last)

Parent/Guardian/Spouse Email

*Date you plan to attend:

*How many people will be attending, including you?

High School:

*Month and Year of High School Graduation:

*Have you previously attended a college or university?

YesNo

If so, what college have you attended?

Gender:

Church/Religious Preference:

*Intended Major/Undecided:

Other areas of interest:

T-Shirt Size

How did you hear about us? (Check all that apply.)

Other

* - Required fields

Inside Trevecca Days