Augustana College

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I will attend Junior Visit Day on: *

Friday, April 26, 2013

Name: *

Address: *

City: *

State: *

Zip: *

Email:

Parent Email:

Phone:

Student's Twitter Handle:

High School:

Year of Graduation:

Academic Interest(s):

Extracurricular Interest(s):

Gender:

Female

Male

I am a foreign exchange student:

Yes

No

Number in my party:

Please send me a lodging guide:

Yes

2001 S. Summit Avenue, Sioux Falls, SD 57197 | 800.727.2844 | 605.274.0770 | +001 605.274.5516 (outside the United States)