Hood College Information Request

Name and Contact Information

First Name

Last Name

Suffix

Birthdate (mm/dd/yyyy)

Student Email

Verify Student Email

Street Address

City

State or Province

Zip/Postal Code

Country

Home Phone

Student Cell Phone

I consent to be contacted by Hood College at the cell phone number provided above. By submitting your mobile number, you agree to receive text messages. You can opt-out at anytime. Message & data rates may apply.

Program Information

Anticipated Entry Term

Anticipated Entry Year

Student Type

Intended Major/Program

High School Graduation Year

What school do you currently attend? Choose Unknown School if no match

PRIMARY PARENT/GUARDIAN INFORMATION:

First Name:

Last Name:

Relationship to Student:

Parent/Guardian Email:

Contact Information