First Name*                                          Last Name*
                              

Address*
 

City*                                                                 State*          Zip Code*
                                                              

Phone Number*                     
              

I am a*
  Freshman Transfer Student Non-Traditional Student International Student

High School*                                             Graduation Year*
                                   

Previous College (if applicable)
 

Campus*
  Aberdeen Eagle Butte, SD Fairmont, MN PC Virtual

Academic Program of Interest*                                            Undecided Biology Business Business Completion (PC Virtual) Chemistry Communication Early Childhood Education English General Studies LPN to BSN (PC Virtual) Medical Assisting Medical Laboratory Technology Medical Office Administration (PC Virtual) Medical Transcription (PC Virtual) Nursing Radiologic Technology Recreation Religious Studies RN to BSN (PC Virtual) Social Work Socail Work Completition (Killian Community College) Surgical Technology

Athletic Program (if applicable)
Not Applicable Baseball Women's Basketball Men's Basketball Women's Cross Country Men's Cross Country Women's Golf Men's Golf Women's Soccer Men's Soccer Softball Volleyball

Preferred Date of Visit*
 

Time of Arrival*
 

Additional Comments