Student Information Form

Semester: Spring 2006 Spring 2007 Spring 2008

Your Name:    
                                    Your Nick Name:

Major: Select One Ag Ed An Sc Pl Sc Ag Bus Gen Ag Vo-Tech Administration -- Graduate Level Agricultural Education -- Graduate Level Other Please state below.

     Other 

Level:     Undergraduate Graduate

Advisor:

Local or School Address:

Local or School Phone:   

Work or Other Phone Number:

Place of Work:

Hometown address if different than local or school address:


Home High School :

Number of College Hours Completed:         

Number of  Hours Enrolled this Semester:

Your Email Address: