College Keep-In-Touch (KIT) Enrollment Form

Student's First Name:
Student's Last Name:
Year in School:
Freshman
Sophomore
Junior
Senior
Graduate or Other
Expected Graduation Date (mm/dd/yyyy):
Expected Degree:
Student's Email Address:
Student's Street Address - line 1:
Student's Street Address - line 2:
Student's Street Address - line 3:
Student's City:
State:
Country:
Student Zip Code:
Parent's First Name:
Parent's Last Name:
Parent's Phone Number:
Email:
label32: