Name:
Social Security #:
Mailing Address:
City, State, Zip:	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA MA MD ME MI MO MN MO MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WY
Phone number:	, home   , cell
E-mail:
Gender:	Select one Male Female
Intended Major:	- select a major - Business Fine Arts Education Languages & Literature Math Physical Education Religion Pre-Professional Science Social Sciences
Session	Session II Saturday July 26
Parents' / Guests' Names:
I will come the evening prior to my registration day to do my placement testing.
	Yes No
Housing needed:	Thursday Friday

******RETURNING STUDENTS CAN ONLY REGISTER ON JULY 26 - FOR MORE INFORMATION, PLEASE CALL 806-291-3500

Office of Admissions
1900 W. 7th, CMB 712
Plainview, TX 79072