CALNS Science Exploration Day                     REGISTRATION FORM

Please complete the form below so that we may best serve you as you visit your new home On The Hill:

Name: Dr. Josh Herring
Department: Food Science

First Name:

Last Name:

High School:

Year/Rank
OtherJunior Senior

Your Science Teacher/Counselor:

Home Address:

City:

State:

Zip:

Email:

Phone:

Please enter your desired program/department or even just what job you want after graduation.

If you have any additional questions or concerns PLEASE let us know and we look forward to seeing you on The Hill.

For security purposes, the information you provide should not include sensitive data (example: social security numbers)