UAEC Virtual Visit at Hillcrest High School (SC)

Student Information

Student's First Name *

Student's Last Name *

Student's Preferred Name

Student's Email Address *

Student's Mobile Phone Number *

May we send your student SMS (text messages)? *

Yes

No

Mailing Address *

Country

Street

City

Region

Postal Code

STUDENT'S HIGH SCHOOL INFORMATION

Student's High School *

Anticipated date of graduation from high school *
If unsure of the exact date, please use June 1st of your graduation year.

Parent / Guest Information

Salutation (ex. Mr., Mrs., Dr.)

Parent/Guardian First Name

Parent/Guardian Last Name

Relationship to the Student

Parent/Guardian Email Address

Parent/Guardian Mobile Phone Number

May we send parent/guardian SMS (text messages)?

Yes

No