PT Major Day Registration Form

Note: Students attending the Major Day will receive a $30 application fee waiver.

*Event Date: 
*First Name: 
*Last Name: 
*Email Address: 
*Address: 
*City: 
*State:  *Zip: 
*Telephone: 
*High School: 
*Class rank: 
*Year of Graduation: 
College Attended:
Possible major: 
*The email used to register will be used for all future correspondence.

Only students interested in studying Physical Therapy should attend PT Major Day. All other students should register to attend our LVC Discovery Day program.
*Extracurricular Activities: