Information Request Form

First Name:

*

Middle Name:

Last Name:

*

Address

Permanent Mailing

Street 1 and Apartment :

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Street 2 (If necessary) :

City:

*

State :

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Zip Code:

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Country :

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Date of Birth:

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Home Phone :

xxx-xxxxxxx

Work Phone :

xxx-xxxxxxx

E-mail Address :

Best Way to Contact

Home Phone Work Phone E-mail

Entry Term:

Spring 2010 Fall 2010 Spring 2011 Fall 2011 Spring 2012 Fall 2012 Spring 2013 Fall 2013

Student Type:

Select Student Type Freshman Freshman International Graduate Graduate International Graduate Non-Degree Graduate Visiting Graduate Visiting from a CUNY institution / Permit Post-Baccalaureate Transfer Transfer International Undergraduate Non-Degree Undergraduate Visiting from a CUNY institution / Permit Undergraduate Visiting *

Possible Major 1:

Possible Major 2:

What prompted you to inquire about Brooklyn College?

--------------------- 1010 WINS: Future Newsmakers AM NEW YORK BROOKLYN FAMILY BROOKLYN PARENT COLLEGE CONFERENCE MANUAL College Newspaper COLLEGEVIEW.COM DAILY NEWS FACEBOOK GRADSCHOOLS.COM GRADVIEW.COM HOBSON'S HISPANIC STUDENT GUIDE fall 06 INTERNATIONAL STUDENT GUIDE TO THE USA MARKETEER METRO NY NEWSPAPER NY TEACHER NY TIMES ONLINE NYMETROPARENTS.COM PETERSON'S COLLEGE & UNIV. ALMANAC 2008 PETERSON'S FOUR YEAR COLLEGE GUIDE 2008 PETERSON'S GRAD STUDIES 2008 PETERSONS.COM PRINCETONREVIEW.COM SCHOOLGUIDES.COM SUMMERONCAMPUS.COM USEDGUIDE.COM USNEWS.COM WWW.GRADGUIDE.COM Z100 --------------------- I Live in the Area BC Alumni BC Brochure Visit BC Campus BC Email BC Faculty BC Student College Day College Fair College Night Counselor/Teacher CUNY Info Fair CUNY Office of Admissions Services CUNY/BA Family Referral Friend Referral Graduate Fair High School Visit Letter from BC School Guide Transfer Fair

 
 Obtain the High School code for your high school:

University or College Attended/Attending:

 
 Obtain the College Board code for your college:

Honors:

Yes No