First name
Last name
Street address
City
State/Province
Zip/Postal Code
Country
Home Phone(###)###-####
Cell Phone
Email
Parent's Email
PSAT Total
SAT Total
ACT Composite
Cumulative GPA
Date you plan to visit campus
Time you plan to arrive on campus	Select a Starting Time of Visit 8:00 AM 8:30 AM 9:00 AM 9:30 AM 10:00 AM 10:30 AM 11:00 AM 11:30 AM 12:00 PM 12:30 PM 1:00 PM 1:30 PM 2:00 PM 2:30 PM 3:00 PM 3:30 PM 4:00 PM
Number of Visitors
Special Accommodations

While visiting Trine I would like to (check all that apply)

Meet a Professor

Take a campus tour

Meet with a coach

See a typical dorm room

Talk with financial aid

Meet with a music adviser Band Choir
(Check both, if applicable)

Visit Christian Campus House

Intended college major Select Major Accounting Associate in Accounting Associate in Business Administration Associate in Criminal Justice Biology Biomedical Engineering Biomedical/Chemical Engineering Dual Degree Biomedical/Electrical Engineering Dual Degree Biomedical/Mechanical Engineering Dual Degree BS Accounting/MS Leadership BS Business Administration/MS Leadership BS Communication/MS Leadership BS Entrepreneurship/MS Leadership BS Finance/ MS Leadership BS Golf Management/ MS Leadership BS Management/ MS Leadership BS Marketing/ MS Leadership BS Sports Management/ MS Leadership BS/ME Civil Engineering BS/ME Mechanical Engineering BS/ME Mechanical Engineering/Biomedical Eng Grad BS/MS Criminal Justice Business Administration Chemical Engineering Chemistry Civil Engineering Communication Computer Engineering Criminal Justice Design Engineering Technology Electrical Engineering Elementary Education Entrepreneurship Exercise Science Finance Forensic Science General Business General Education General Engineering General Studies - (Pre Legal) General Studies - Self Designed General Studies - Social Studies General Studies Arts and Sciences Golf Management Health/PE Ed (K-12) Informatics Management Marketing Mathematics Education Mathematics Mechanical Engineering Music Psychology Science Education Chemistry Science Education Life Sci(Bio) Social Studies Education Sport Management Undeclared

Date you plan to enter Trine University Choose a term Fall semester, 2013 Spring semester, 2014 Fall semester, 2014 Fall semester, 2015

Select a Career Path: Select a Career Path Business Engineer Education Scientist Doctor Law Enforcement Dentist Veterinarian Lawyer Nurse Pharmacist Psychologist Social Worker Journalist Other

If you plan to participate in any sports please check the appropriate box below:

Please list your hobbies or extracurricular activities.

Please use the box below to enter any comments.