Mesa Experience Registration Form

Check the Date(s) attending:
Program		Dates
	The Mesa Experience	Saturday, February 27th
	The Mesa Experience	Friday, March 26th
	The Mesa Experience	Saturday, April 17th

Total number of people attending.
(*Please note a non-refundable $15.00 fee for each person attending, payable at program.)

First Name M.I.
Last Name
Mailing Address
City State Zip
Phone Number
Cell Phone Number
May we text you? Yes No
Email Address
High School/College
Birthdate
Graduation Year
GPA ACT/SAT Score
Academic Major
Ethnic Background (optional)

Registration Info

Please complete and submit the form below to participate in one of the many Admissions programs that Mesa State College has to offer. The cost of $15.00 per program includes meals and materials and is nonrefundable. Your family can join you for an additional $15.00 per family member. Payment is due when you arrive to your selected program. Please register at least one week prior to the program.

Student at mesa experience