First Name :
Last Name :
Student’s Email :
Parent’s Email:
High School Graduation Year:
High School Name:
I plan to start at Iowa as a(n)...
Incoming freshman
Transfer student
Number of guests you'll bring with you:
(maximum
of two guests, please)
Phone Number: (
)
Address:
City:
State:
Zip:
I would like to attend
on:
Saturday, December 5th, 2009 (due to popular demand, this program is full)
Saturday, January 23rd, 2010
Saturday, February 20th, 2010
Saturday, March 27th, 2010
Saturday, April 24th, 2010
I would like to attend a complementary lunch with Engineering Student Ambassadors at 12:15 PM in Burge/Hillcrest Marketplace
(guests with prospective student will receive a complementary coupon(s) to dine for a discounted rate of $5.50)
You will receive a confirmation email with more information. If you do not receive a
confirmation email, please contact us at ambassdr@engineering.uiowa.edu.
Individuals with disabilities are encouraged to attend all University of Iowa-sponsored events.
If you are a person with a disability who requires an accommodation in order to participate in this program, please contact the Admissions Visitors Center in advance at 1-800-553-IOWA.
If you have any other comments or questions, please let us know: