Request Information

* required

First Name* 
Middle Name 
Last Name (Family Name)*
Gender*  Female  Male
Address*
Address Line 2
City/Town*
State*
Zip/Postal Code* 
Country*
Home Phone*
Cell Phone
E-mail Address* 
College Attended*
School CEEB Code*  CLICK HERE to find your school
Year of Graduation   (yyyy)


Anticipated Date of Enrollment* 
1st Academic Interest  
2nd Academic Interest  
1st Athletic Interest  
2nd Athletic Interest  
Comments, questions,
or additional programs
of interest

Regis College Undergraduate Admission: Request Information
Undergraduate, Admission, Information
Undergraduate Admission Request Information Form