Welcome and thank you for your interest in the University of the District of Columbia! Please take just a few minutes to fill out this form so we can learn a little more about you and how UDC can best meet your academic, personal and professional needs.

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Prospect Entry Term
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Prospect Name
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First Name:
Middle Name:
Last Name:
Suffix:
Nickname:

Primary Address
Valid From:	Month Day Year (YYYY)
Until:	Month Day Year (YYYY)
Address Line 1:
Address Line 2:
Address Line 3:
City:
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Nation:
Phone Number:	- (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

E-Mail Address
E-mail Address:
Verify E-mail Address:

Prospect Birthdate
Date of Birth:	Month Day Year (YYYY)

Prospect Student Type
Student Type:

Prospect Major
Major:

Select your High School from the 'Look Up High School Code' Icon. If your High School is not listed, enter '9998' in the High School Code field and manually enter the High School Address.

Prospect High School
Home Schooled (check for yes):
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High School Code:
High School Name:
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Address Line 2:
Address Line 3:
City:
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Nation:
Graduation Date:	Month Day Year (YYYY)
Class Rank and Size:	/ (must be numeric)
GPA:	(example: 9.99, or A+)

Select your Prior College using the 'Look Up Prior College' Icon. If your College does not exist, enter '9999' in the College Code field and manually enter the address of your college.

Prospect Prior College
College Code:
Prior College Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Attended From:
Attended To:
Graduation Date:	Month Day Year (YYYY)
GPA:	(example: 9.99)
Degree:

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Interests:

How Prospect Learned About UDC
How I Learned About UDC:UDC

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