First Name:

Last Name:

Relationship to Child

Relationship:

Street:

City

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Preferred Email Address:

Are you a WCSU Alumni?

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Year Graduated:

Degree/Major:

Other connections to WCSU

Current WCSU Student's Full Name:

Major:

Anticipated Graduation Year:

Student Type

ResidentCommuter

Name:

Major:

Class of/Anticipated Graduation Year