Yavapai College : Information Request Form

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Yavapai College > Admissions > Information Request Form

* Required Fields Thank you for your interest in Yavapai College! Please complete the form below to obtain information about Yavapai College.
1. Contact Information
Last Name *
First Name *
Middle Initial *
Address *
Address 2
City *
State *
Country *
Zip Code *
Email Address
Home Phone Please include area code: xxx-xxx-xxxx
Cell Phone Please include area code: xxx-xxx-xxxx
Sex
Date of Birth * Please use following format: mm-dd-yyyy
Father's Name
Mother's Name
2. School Information
Name of High School Attended*
Graduation Year *
High School City
High School State
Your Current Status	Public High School Student Private School Student Charter School Student Home School Student GED Recipient College Transfer Currently Employed Retired Other
3. Your School Grades
Grade Point Average
ACT Score
SAT Score
Class Rank
4. Anticipated Enrollment Timeframe
Anticipated Enrollment Semester
Anticipated Enrollment Year
5. Academic Interests
Primary Academic Interest
Secondary Academic Interest
If there is an academic program you are interested in, but is not specified in the above lists, please enter it here
6. Extra-Curricular Interests
Do you have extra-curricular interests? Please list: ie., student government, clubs ...
7. Athletic Interests
Intercollegiate athletic interest	Men's Baseball Men's Basketball Men's Soccer Women's Basketball Women's Softball Women's Volleyball
8. Learn more about Yavapai College
Please send me more information about Yavapai College	YC Catalog Admissions Financial Aid Housing Viewbook Program of Study Guide Current Class Schedule
9. Level of Interest in Yavapai College
Please rate your interest in Yavapai College	Strong Moderate Somewhat

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