Information Request

Colorado College Information Request Form





	Personal Information
*First Name
Middle Initial
*Last Name
Suffix (Jr, III, etc.)
Gender	Female Male
Date of Birth (mm/dd/yyyy)
	Contact Information
*Street Address 1
Street Address 2
*City or Town
*State / Province / Region	Other
Zip / Postal Code
Country
HomeTelephone (xxx-xxx-xxxx)*
*E-mail Address
	Academic Information
*Enrollment Type
*Anticipated Semester of Entry
High School or College
High School CEEB Code
Academic Interest #1 (choose one)
Academic Interest #2 (choose one)
Academic Interest #3 (choose one)
Athletic Interest #1 (choose 1)
Athletic Interest #2 (choose one)