Georgian Court University Undergraduate Inquiry Form

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  Ms.   Mrs.   Mr.
First Name: *  Last Name: *  Middle Initial: 
Address: *
 
City: *  State: *  Zip Code: *
Country (Int'l only):
Email: Phone(include area code): 
Gender: Female  Male   Ethnicity:
Birth Date: (format mm/dd/yyyy)

Student Type:Freshman  Transfer
Entry Year: 2015  2016  2017  2018   |  Entry Term: Fall  Spring
*Intended College:   *Interest:
2nd Interest:   Athletic Interest:
High School Name:   School Code:  Search
Prev. College Attended:   College Code:  Search
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* Indicates a required entry