High School Days Registration Form

Office of Admissions 1-800-950-YORK

Your Information:

* Denotes required fields
First: *
Last: *
Preferred Name: *
Gender (M/F): *
Grad Date (mm/yy): * Birth Date: *
Do you plan to pre-enroll? (for seniors only) (Y/N):
Major:
Parents:
Home Congregation:
Are you coming with a group? (Y/N):
Would you like campus housing? (Y/N):
Preferred Host (Optional):
Estimated Arrival (Date & Time):
Do you have any special needs/medical concerns? (Y/N):
If "yes", please list your special needs/medical concerns.
Street Address: *
City: *
State: *
Zip: *
Phone Number:
Email:

Admissions:

Prospective Students
Parents
Church Leaders
Transfer Students
International Students
Homeschool Students

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