Bed & Breakfast Registration (Day or Overnight)

Personal Information

*First name: *Last name: *Email:

Gender: Male Female

Contact Information

*Street address:
*City:
*State:
*Zip:
*Primary Phone:
Secondary Phone:

Academic Information

Semester and year you are planning to attend Evangel:

What year did (or will) you graduate from High School?:

Have you applied to Evangel? Yes No

What type of student will you be?
a freshman
a transfer (more than 24 college credits when you enroll at Evangel not including dual-enrollment)

Academic Area(s) of Interest (please be specific; e.g. piano, voice performance, special education, sculpting):

Visit Information

*Date of visit — see special dates below before entering your date:

Is your visit in conjunction with Music Days?

Yes No

Will you be staying in a residence hall overnight?

Yes No

If so, which night will you be staying over?

Thursday Friday

Who do you plan to stay with?

A friend on campus A Bed and Breakfast host

Time of arrival: 8-9 a.m. 9-10 a.m. 10-11 a.m. 11 a.m.-noon noon-1 p.m. 1-2 p.m. 2-3 p.m. 3-4 p.m. 4-5 p.m. 5-6 p.m. 6-7 p.m. 7-8 p.m. 8-9 p.m. 9-10 p.m.

Who will be attending with you? (names and relationships)

Additional comments

*denotes required field

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