Questionnaire for Marcus - Messiah University

Questionaire

1. First name: Required

2. Last name: Required

3. Address:

4. City:

5. State

6. Zip code:

7. Phone#:

8. Name you prefer to be called:

9. Birthdate:

10. Academic interest(s):

11. Extracurricular interests:

12. How did you first learn about Messiah?

13. Have you been on campus before?

14. If YES, why?

15. How would you prefer me to contact you?

Mail Phone Email

16. Best time to reach you?

17. Email address: Required

18. High school:

19. Graduation date:

20. Do you have any additional comments or questions?