Roanoke Undergraduate Nursing Open House

Student Information

First Name

Preferred First Name

Last Name

Birthdate

Student Email Address: Please do not use school associated email address

Mobile Phone Number

Do you give Radford University permission to send you important updates regarding your upcoming visit(s), and/or other important information via text messaging? (Standard message charges apply.)

Yes

No

Do you give permission to receive telephone calls that deliver AI messages about Radford University at this phone number?

Yes

No

Mailing Address

Country

Street

City

Region

Postal Code

Academic Information

What will your application type be when you apply?

New Freshman

New International Freshman

Transfer

International Transfer

What are you interested in studying?

When do you intend to start at Radford University?

High School Information

College Information

Current School:

Event Information

How many people, including yourself, will be attending the visit? Students are limited to 2 guests at this time.

1

2

3

Do you or your guests require any mobility or auditory accommodations for the event?

Yes

No

Please provide details about your accommodation needs:

Would you like for us to copy a guest on event-related communications?

Yes

No

Guest Information

Guest Relationship Type

Guest First Name:

Guest Last Name:

Guest Email Address

Once you submit your registration, you will receive a confirmation email and follow up reminders closer to the visit date. If nothing arrives after a few hours initially, check your spam/junk folder just in case our confirmation email lands there! Feel free to contact us at admissions@radford.edu for additional assistance if needed.

We look forward to seeing you on campus soon!