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Prospective Undergraduate Student - Visit to CBC Request
Prospective Undergraduate Student - Visit to CBC Request
You must have JavaScript enabled to use this form.
Your name:
Your email address:
A phone number where you can be reached during the day:
What is your intended major?
Biochemistry
Chemistry
Will you be an honor student at the University of Arizona?
Yes
No
Name of the high school you are currently attending:
If not in Arizona, where is your high school located?
Are you a junior or senior?
Junior
Senior
Date & time you wish to schedule your visit:
Date & time you wish to schedule your visit:: Date
Date & time you wish to schedule your visit:: Time
Please indicate an alternate date and time for your visit:
Please indicate an alternate date and time for your visit:: Date
Please indicate an alternate date and time for your visit:: Time
Is your start time flexible?
Yes
No
Special requests:
Submit
Leave this field blank