Allegheny College

Individual Visit Form

Please complete the following form to request a visit to campus.

Prefix*

Mr.

Ms.

Student's First Name*

Student's Last Name*

Address*

City*

State*

Zip*

Student Email Address*

Parent Email Address

Home Phone Number*

Cell Phone Number

High School*

Year of Graduation*

If you indicated more than 1 academic interest, please rank them in order of importance to you

(i.e. 1. Biology, 2. Psychology, 3. English, 4. Theatre, etc.)

Key extracurricular activities

What day of the week do you wish to visit?*

If you wish to visit on a Saturday please complete this form.

What month of the year?*

What date?*

Choose a time for your appointment*

Are there additional appointments you would like to schedule?

Fields marked with an * must be filled in.

Please enter the words you see below in the box.

If the words below are difficult to read, please use the refresh button to the right of the words.