Preferred date for visit: (Please click for calendar)
(Please schedule 5 days in advance, so we may arrange visits with coaches and faculty.)
Preferred time of visit :
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
Home Phone: (ex. 9999999999)
Cell Phone (optional): (ex. 9999999999)
Email:
__________________________________________________________________________________
Current High School / College Name:
Year of Graduation: (ex. 9999)
What type of student are you?

Please select the Majors and/or Pre-Professional Area that interest you.

(Majors prepare students for work in a field which they may enter upon graduation or for
graduate work in their field of choice.)


Intended Major Area(s) of Study:

1st choice:
2nd choice:


(Pre-professional programs of study require from one to four years of preparation at Midland,
followed by transfer to the professional school, which offers the specialized training.)

Optional Pre-Professional Area:


If you intend to participate in university sports, please select from the options below...
Sports (1st choice):
Sports (2nd choice):


If you intend to participate in other university activities, please select from the options below...

Fine Arts (1st choice):
Fine Arts (2nd choice):


Extra Curricular (1st choice):
Extra Curricular (2nd choice):
__________________________________________________________________________________

Yes, I want to meet with a
Coach Fine Arts Director
Promo Code/Who Sent You:
After submitting this form, you will get an email confirming that your request was received. If you don't receive an email, please call Midland Admissions at 800-642-8382 x 6503.