UMBC Visit Days

Check date below. Please register at least one week prior to the event.
Friday, November 19, 2010 Friday, December 3, 2010	Total number in party            (including the student)

	Student's Name
	E-mail Address (Required for e-mail notification)
	Street Address
	City
	State
	Zipcode
	Home Phone
	Special Accommodations Needed Regarding a Disability
	Current School
	Year of High School Graduation

Is the student a child of a UMBC alum?

Yes

No

	If yes, please provide the following:
	Alum Parent Name
	Alum Parent Class Year
	Alum Parent E-mail Address
	Alum Parent #2 Name (if applicable)
	Alum Parent #2 Class Year (if applicable)
	Alum Parent #2 E-Mail Address (if applicable)

Intended Semester and Year of Enrollment	Fall	Spring	Year

Academic Interest:
I am interested in learning more about one of the following UMBC Scholars Programs as part of my Visit Day:	Center for Women and Information Technology Scholars Program Humanities Scholars Program Linehan Artist Scholars Program Meyerhoff Scholars Program (Science, Engineering, and Math) Sherman Teacher Education Scholars Program Sondheim Public Affairs Scholars Program