1.

First Name:

2.

Preferred Name (nickname):

3.

Last Name:

4.

Email address:

5.

Home phone number with area code:

6.

Student cell phone number:

7.

First choice (date desired):

June 20, 2008

August 23, 2008 (this date is reserved for students who live 300+ miles away from campus)

8.

Second choice (date desired):

June 20, 2008

August 23, 2008 (this date is reserved for students who live 300+ miles away from campus)

9.

Parent/Guardian Name:

10.

Parent/Guardian Name:

11.

Which placement exam do you wish to take:

French

German

Spanish

Latin

Greek

I wish to start a new language while at Hanover

12.

Are you planning to pursue a teacher certification?

Yes

No

13.

Are you planning to major in pre-med?

Yes

No

14.

Intended Major:

15.

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