Nursing Info Session

1. First Name *
2. Middle Initial
3. Last Name *
4. Gender * Male Female
5. Address *
6. City *
7. State Select State Non-USAL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA WA WV WI WY
8. Zip Code
9. Country
10. Phone *
11. E-mail *

1. High School *
2. High School Grad. Year *
3. Transfer Credit * Yes No
4. Previous College
5. Semester to attend Northwest * - Select One - Fall 2012 Spring 2013 Fall 2013 Spring 2014 Fall 2014 Spring 2015 Fall 2015 Spring 2016 Fall 2016 Spring 2017

1. Visit Date *
2. Additional Guests
   List their names and your relation to them (Mother, Brother, Chaperone, etc)

Two weeks notice is required for overnight stays. Two-night maximum stay. Housing, class visits and chapel are not available during holidays, spring break and summer break. Prospective students will be placed with a current student. Other guests can be placed in hospitality housing on campus for a small fee.

1. Would you like to stay overnight on campus? * Yes No
2. If yes, please provide the following information:
   Which night would you like to stay? - Month - January February March April May June July August September October November December - Day - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - Year - 2011 2012 2013
3. Arrival time on campus?
4. Is there a NU student with whom you'd like to stay?