Personal Information - Suspect Prospect Boomi Test 7

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Suspect Prospect Boomi Test 7

Sunday, November 8, 2026 at 10:00 AM

Holland Yates Hall Admissions Center

100 East Grace Street

Harrisonburg, VA 22801

Student Information

Fill out the information below, then click Next to continue.

* Student's First Name

* Do you have a preferred name you would like to be addressed by?This question is required.

Yes
No

Student's Middle Name

* Student's Last Name

Gender

Gender

Are you Hispanic/Latino?

Race/Ethnicity

Are you a U.S. citizen?

Yes
No

* Student's Email Address

*

Would you like to send a copy of the confirmation email to a guest?

This question is required.

Yes
No

Mailing Address

* Country/Region

USA

* Street

* City

* State/Province

* ZIP/Postal code

Text Message Opt-In

Yes
No

Student's Cell Phone

* Do you plan to apply as a First-Year or Transfer Student?This question is required.

* Expected Entry TermThis question is required.

* Intended MajorThis question is required.

* Current High School/College

* School Street

* School City

* School State/TerritoryThis question is required.

* School Zip Code

Guest Information

How many guests will you bring?

* Special AccommodationsThis question is required.

* Special Accommodations Details