UG Inquiry Form - Aleshire Center

Thank you for your interest in the Aleshire Center for Leadership & Community Engagement at Washburn University!

* Denotes Required

Biographical Information

First Name

Last Name

Date of Birth

Which of these student types best describes you?

Freshman: I am currently a high school student or recently graduated

Transfer: I am currently a college student attending a different school

Adult Learner: I have never attended college and have been out of high school for longer than one year

Current Student: I currently attend Washburn University

Adult T-Shirt Size

Please send me more information about:

Bonner Leader Program

Community Studies Minor

Leadership & Community Engagement Living-Learning Community

Leadership Studies Minor or Certificate

Scholarships

Contact Information

Email Address

Cell Phone

Would you like to receive texts from Washburn University?

Yes - Go Bods!

No thanks.

Permanent Address

Country

Street

City

Region

Postal Code

Parent Contact Info

Would your parent(s) or guardian(s) like to receive information, as well?

Yes

No

Person 1 First Name

Person 1 Last Name

Person 1 Email Address

Person 1 Cell Phone

How is this person related to you?

Would this parent/guardian like to receive texts from Washburn University?

Yes - Go Bods!

No thanks.

Add Another?

Yes

No

Person 2 First Name

Person 2 Last Name

Person 2 Email Address

Person 2 Cell Phone

How is this person related to you?

Would this parent/guardian like to receive texts from Washburn University Admissions?

Yes - Go Bods!

No thanks.

Academic Information

Which high school do you attend?

Which high school did you attend?

Expected Graduation Date

Which college do you currently attend?

When would you like to begin at Washburn University?