Dual Enrollment Inquiry Form

Student Information*

*denotes a required field.

Student Email Address*

Student First Name*

Student Last Name*

Student Preferred Name

Student Birthdate*

Student Gender

Student Cell Phone*

Student Mailing Address*

Country

Street

City

Region

Postal Code

Parent or Guardian Information

First Name*

Last Name*

Cell Phone*

Email Address

Relationship Type*

Education*

Are you a high school or homeschooled student?*

Yes

No

Anticipated Start Term*

Fall

Spring

Year entering the University of Nevada, Reno as a dual enrollment student*

What school do you currently attend?*

Interests