Open House Reservation Form
  
Complete this form to reserve a space for one of our upcoming Open House programs:
(* indicates required fields)

Date:*
Student First Name:*
Student Last Name:*
Number of people attending:*
Address:*
City:*
State:* Zip:*
Phone:*   
Student Email:*
Verify Student Email:*
Birth Date:*
High School:*
CEEB Code:
Year starting college:*
Entry Status:*

What is your ethnicity?:
Hispanic or Latino
Persons of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin, regardless of race.
Not Hispanic or Latino

What is your Race? (Select One or More):
American Indian or Alaska Native
Persons having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
Asian
Persons having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Black or African American
Persons having origins in any of the black racial groups of Africa.
Native Hawaiian or Pacific Islander
Persons having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific islands.
White / Caucasian
Persons having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Have you applied?:*
Yes
No

Do you plan to stay for lunch?*
Yes
No

 Are you attending the financial aid session?*
Yes
No

Areas of interest:

How did you hear about us?


Need help finding us? Get a map and directions to Shippensburg or view a map of campus.

For area lodging information, click here.