Mesa Experience Registration Form

Check the Date(s) attending:
Program		Dates
	The Mesa Experience	Saturday, Feb 26, 2011
	The Mesa Experience	Friday, March 25, 2011
	The Mesa Experience	Saturday, April 16, 2011

Total number of people attending.
(Please note: Total attending exceeding 3 people will pay a non-refundable $15.00 fee per additional person, payable at program check-in.)

First Name M.I.
Last Name
Mailing Address
City State Zip
Phone Number
Cell Phone Number
May we text you? Yes No
Email Address
High School/College
Birthdate
Graduation Year
GPA ACT/SAT Score
Academic Major
Ethnic Background (optional)
Special Requests or Accommodations:

Registration Info

Please complete and submit the registration form to participate in one of the many Admissions programs that Colorado Mesa University has to offer.
Cost for the program is FREE for the student and 2 guests (3 people total). Any additional guests will pay a non-refundable $15.00 fee per person. Payment for additional guests will be due at check-in when you arrive at your scheduled program.

Registration for your selected program at least one week in advance is appreciated.

Student at mesa experience