Rumble in the Jungle

Student Information

First Name

Preferred Name (only if different from First Name)

Middle Initial

Last Name

Email Address

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Mobile Phone Number

May we contact you via text message at the number you supplied?

Yes

Your Education Level

I am currently working on, or have recently earned a:

Student Type

Pittsburg State University defines a First year student as:

Currently in high school, or
Recently graduated from high school or completed GED, or
Completed LESS than 24 college credit hours

Pittsburg State University defines a transfer student as someone who has completed more than 24 college credit hours after graduating from high school.

High School Information

School Name Search (Name, City, CEEB): Please start typing your school's name and click on the result to populate the address information. If your school is not listed, please start by typing "Unlisted" in the field below. Please do not abbreviate.

School Code (This will populate once you select a school from the dropdown list above)

Attention

Please select your institution from the dropdown list. If your institution is not listed, please indicate the type of institution you are attending by typing in "Unlisted" in the search box.

College Information

School Name Search (Name, City, CEEB): Please start typing your school's name and click on the result to populate the address information

If your school is not listed, please type 'Unlisted' in the field below. Do not use abbreviations.

Attention

Please select your school from the dropdown list. If your institution is not listed, please indicate the type of school you are attending by typing in "Unlisted" in the search box.

Start Term

Anticipated Start Term

Primary Program of Interest

What type of program are you interested in?

Program Category

Program

Do you have a secondary program of interest?

Secondary Program of Interest

What type of program are you interested in?

Program Category

Program

Parent Information

Relationship to Student

Parent First Name

Parent Last Name

Parent Email

Parent Mobile Phone Number

Do you want to provide another parent's information?

Yes

Parent 2 Relationship to Student

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email

Parent 2 Mobile Phone Number

Questions

Please list any questions that we can address for you.

Please be aware that all registrations are final, and no refunds will be available.

Amount Due
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Amount Due