Spring Open House

Student Type*
*Program of interest and start term will display once student type is selected

First Name

Last Name

Email Address

Phone Number

Birthdate

First Name

Last Name

Email Address

Phone Number

What school are you associated with?

I will be studying as a

Academic Program of Interest

When do you plan to begin your degree?

I will be studying as a

Program of Interest

I plan to begin my studies in

I will be studying as a

Program of Interest

I plan to begin my studies in

I will be studying as a

Program of Interest

I plan to begin my studies in

Number of Guests

Do you require ADA accommodation?

Yes

No

If yes, please specify:

Do you plan on having breakfast with us?

Yes

No

Do you have dietary restrictions?

Yes

No

If yes, please specify:

I consent to and authorize the use and reproduction by you — the University of Bridgeport — or anyone authorized by you, of my name, statements of information attributable to me, and my likeness, including any and all photographs and video which you have taken or will take of me, for any purpose related to the University of Bridgeport, without further compensation to me. All photographs and video footage you have taken or will take of me, or those provided by me to you, including photograph prints and video reproductions, shall constitute your property, solely and completely.

Yes

No