request for information

i'm requesting information as a: *

personal information

preferred first name *

last name *

email address *

mobile number *

mailing address *

country

street

city

region

postal code

birthdate *

religious preference

are you a veteran?

do you wish for a parent to receive information about lipscomb?

parent type

parent first name

parent last name

parent email address

academic information

i would be starting at lipscomb in: *

are you a lipscomb legacy student? * (lipscomb defines legacy students as students who have had a parent, grandparent, or sibling attend lipscomb.)

please indicate your legacy relationship(s)

brother(s)

father

grandfather

grandmother

mother

sister(s)

most recently attended school *

high school *

primary academic area of interest *

interaction - web inquiry (hidden)