PT Major Day Registration Form

Note: Students attending the Open House will receive a $30 application fee waiver.

*First Name: 
*Last Name: 
*Email Address: 
*Address: 
*City: 
*State:  *Zip: 
*Telephone: 
*High School: 
*Class rank: 
*Year of Graduation: 
Possible major: 
*Extracurricular Activities: