March Break Open House Registration Form

Saturday, March 12, 2016

Advance booking is required. Each prospective student should submit a separate registration form.
Once registered, you will receive an email outlining the day, directions to campus, and important links to any other information you may require.

First Name
Last Name
Gender Male       Female
State/Region (If Applicable)
Postal / Zip Code
Contact Phone Number
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: