North Carolina A&T State University Admissions

Information Request Form

Your Name: (required)
E-mail Address:
Telephone:
Gender:	Male Female
Date of Birth:	MM/DD/YY
Ethnic background:	Native American or Alaskan Native Asian or Pacific Islander Hispanic	Black [non Hispanic origin] Caucasian [non Hispanic origin] Other:
Name of High School/ College/Company:
High School Graduation Date:	(required)
Expected Entry Date:	FallSpringYear (e.g. 2000) (required)
Intended Major:
Your Mailing Address: (required)	Street or PO BOX
	City County StateZip Code
Optional Information:	S.A.T. V S.A.T. M	A.C.T High School G.P.A
What information do you want?	Application for Undergraduate Admission University Brochure/Viewbook Financial Aid Information
Comments or Questions: