In Person: Christina Quimby Interview

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General Information

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Last/Family Name*

Preferred Name

Pronouns (Optional)

Sex

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Birthdate*

Contact Information

Mailing Address*

Country

Street

City

Region

Postal Code

Email Address*

Confirm Email Address*

Home Telephone

Text message opt-in*

Yes, I would like to receive text messages from Mount Holyoke College

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Mobile Phone

School Information

Please refer to these descriptions when selecting the type of prospective student you are:

First-year student (current high school student or younger)
Frances Perkins student (non-traditional age student 25 years and older)
International guest student
Transfer student (current college student age 24 years and younger)

I am a prospective:*

First-Year

Frances Perkins

Transfer

Anticipated Entry Term*

Graduation Year*

Prospective first-year students should enter the name of high school below; prospective transfer students should enter name of college/university. Homeschooled students who are not a part of a homeschool association, or who belong to an association not listed below, should enter "Home School Clearing House." If not currently enrolled in school, enter the name of the last institution attended.

School Name*

School CEEB

College Access Program, if applicable (i.e. A Better Chance, Posse, Prep for Prep, etc.)

Academic and Extracurricular Activities

Select up to 3 academic interests:

Primary Academic Interest

Academic Interest 2

Academic Interest 3

Select up to 3 athletic interests:

Sport 1

Sport 2

Sport 3

Select up to 6 extracurricular activities (Hold the Ctrl key to select multiple items)

Parent/Guardian Information

Parent/Guardian 1

First/Given Name

Last/Family Name

Does this parent/guardian share my mailing address?

Yes, this parent/guardian shares my mailing address

No, this parent/guardian has a different mailing address

Enter Parent/Guardian 1 address if different from student.

Country

Street

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Parent/Guardian 2

First/Given Name

Last/Family Name

Does this parent share my mailing address?

Yes, this parent/guardian shares my mailing address

No, this parent/guardian has a different mailing address

Enter Parent/Guardian 2 address if different from student.

Country

Street

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Traveler Comments

In Person: Christina Quimby Interview

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