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Student Information

First Name

Last Name

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Email Address

Mobile Phone Number

Academic Interests

Student Type

What major or program are you interested in?

High School Graduation Year

High School Name

When would you like to start classes at UH?

Are you interested in The Honors College?

Yes

Have you submitted an application to the University of Houston?

Yes

Guest Information

How many guests will the student be bringing on this visit? (limit 2)

Guest 1 First Name

Guest 1 Last Name

Guest 1 Email

Guest 2 First Name

Guest 2 Last Name

Guest 2 Email

Visit Information

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Do you have any accessibility needs for your visit (i.e. mobility assistance, Spanish language, sign language interpretation)? If yes, please follow the instructions that appear below.

Yes

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