Admissions Inquiry Form

Please select the weekday date and time you would like to schedule a visit from the options below:
 
*Preferred Visit Date
  
*Preferred Time
(Submitting an online request does not guarantee a visit; however we will do our best to accommodate your request. If a weekday does not work, or you are looking to visit at a different time slot, please give us a call and we will be happy to work with you. Phone: (901) 321-3205.)
 
CONTACT INFORMATION
 
*First Name
*Last Name
 
*Street Address
Street Address Continued
*City
*State
*Zip/Postal Code
 
*Phone Number
(xxx-xxx-xxxx)
Cell Phone Number
(xxx-xxx-xxxx)

Cell Phone Provider
 
*Student E-mail Address
 
Parent's E-mail Address:
ACADEMIC INFORMATION
 
*When enrolling in college, will you be a...
 
*What year will you enter college?
*1st Major of Interest
2nd Major of Interest
 
High School CEEB Code
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*High School
*Graduation Date
  
Most Recent College/University (If applicable)
 
RSVP
 
All campus visits include a 15 minute session with an admissions counselor and a 45 minute tour.
Please indicate in the space provided any additional activities you would like to participate in during your campus visit.
 
T-Shirt Size
 
PIN (Not Required)
Do you require any special
assistance during your visit?   wheelchair_image
 
 
 
This form was completed by a CBU employee
 

Clicking the Submit button below constitutes your express written consent to be called and/or texted by CBU at the number(s) you provided, regarding furthering your visit to campus. You understand these calls may be generated using an automated technology