Name and Contact Information

First Name

Last Name

Verify Email

City

State or Province

Home Phone

Would you be interested in receiving text messages with information about Averett University?

YesNo

If so, please provide your mobile number.

Mobile Phone

Visit Information

(SPECIAL EVENT) WOULD YOU LIKE TO ATTEND OUR VIRGINIA PRIVATE COLLEGE WEEK? Choose from the below dates and times!

Outside of special events what date would you like visit (Please do not schedule a visit on a weekend or holiday without prior approval)?

What time would you like to visit?

Would you like to visit additional campus locations?

What sport are you interested in (if applicable)?

Are there any special accommodations needed for your or your family members to access our campus?

Program Information

Anticipated Start Term (Spring begins in January; Fall in late August)

Anticipated Start Year

Anticipated Major/Program

What school do you currently attend? Choose Unknown School if no match

If you chose 'Unknown School', please type the name of your current school and include city and state (if applicable)

Current School Start Date

Current School End Date (if applicable)