Fall Preview Day Registration Form
November 15, 2015

Advance booking is required. Each prospective student should submit a separate registration form.
Please indicate the total number of people that will be in your group (including family and friends).

First Name
Last Name
State/Region (if applicable)
Postal / Zip Code
Contact Phone Number
Gender Male       Female
Birthdate / /
Total people in your group
Main Academic Program of Interest
Are you interested in the Ivey Business School Honors Business Administration (HBA) program? YES       NO
Are you interested in either of our Scholars Programs - Scholar's Electives or Western Scholars? YES       NO

The personal information on this form is collected under the authority of the University of Western Ontario Act, 1982, as amended.  To view the complete Personal Information Collection Notice visit the online Academic Calendar at: http://www.westerncalendar.uwo.ca/2015/pg5.html