Registration Form

JOIN US: 
on Our Spring 2022 College Tour
(1-Day Tour)

to NC A&T University
and NC Central University

April 19th, 9 am – 5 pm

Cost: $20

Student Information
Student's Date of Birth
Student's Gender
Student's T-Shirt Size
High School Information
College Information
Parents/Guardian Information
Emergency Contact Information: In the case that above Parent/Guardian can not be reached.
Health / Medical Information
Would you like to purchase travel insurance?
Additional Information
I hereby declare that all the above information furnished is true to the best of my knowledge and belief.
Student Information
Student's Date of Birth
Student's Gender
Student's T-Shirt Size
High School Information
College Information
Parents/Guardian Information
Emergency Contact Information: In the case that above Parent/Guardian can not be reached.
Health / Medical Information
Would you like to purchase travel insurance?
Additional Information
I hereby declare that all the above information furnished is true to the best of my knowledge and belief.
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