Personal Information: Personal information including your name, address, telephone number(s) and e-mail address
Last Name
 Enter your last name 

First Name
 Enter your first name 

Middle
 Enter your middle name or middle initial 

Date of Birth
  (mm/dd/yyyy) Enter your date of birth 

Citizenship
 Select your country of citizenship from the drop-down menu if you are not a U.S. Citizen 

Home Street Address Line 1
 Enter your home street address 

Home Street Address Line 2
 Enter a second line of your home street address (if necessary) 

Home Street Address Line 3
 Enter a third line of your home street address (if necessary) 

Home City
 Enter the city of your home address 

Home Country
 Select the country of your home address from the drop-down menu 

Home Province or State
 Select the Province or State of your home address from the drop-down menu 

Home Postal Code
 Enter the Postal Code of your home address 

Home Phone Type
 Enter the type of your primary telephone number 

Home Phone Country
 Select the country of your primary telephone from the drop-down menu 

Phone Province/State/City Code
    Enter the code for the area, state, province and/or city of your primary telephone number 

Home Telephone Number
 Enter your primary telephone number (enter only numbers, do not use spaces or other characters) 

Primary Email Address
 Enter your primary e-mail address 

Secondary Email Address
 Please enter your secondary e-mail address (if you use one) 

Additional Telephone Type
 Enter Phone Type of an additional telephone number where you might be contacted 

Additional Phone Country
 Enter Phone Country 

Additional Telephone Area Code
    Enter the area/state/province and/or code for an additional telephone number 

Additional Telephone Number
 Enter the number for an additional telephone 

Mailing Address Line 1
 Please enter the first line of your mailing address (if different than your home address) 

Mailing Address Line 2
 Enter the second line of your mailing address (if different from your home address) 

Mailing Address Line 3
 Please enter the third line of your mailing address (if different from your home address) 

Mailing City
 Enter the City of your mailing address (if different from your home address) 

Mailing Country
 Select the country of your mailing address from the drop-down list (if different from your home address) 

Mailing Address Province/State
 Enter the Province or State of your mailing address (if different from your home address) 

Mailing Address Postal Code
 Please enter the Postal Code of your mailing address (if different from your home address) 

Begin Studies In...
 Select the semester in which you intend to begin your studies from the drop-down menu 


    required and     optional