Last Name * First Name * Date of Birth (MM/DD/YYYY) * University * Fairfield University Quinnipiac University Sacred Heart University Southern Connecticut State University University of New Haven Wesleyan University Western Connecticut State University Yale University Intended Major * Email (must be a .edu address) * Cell Phone Number * (xxx) xxx-xxxx Full Home Address (must include Street Address, City, State and Zip Code) * School Address (must include Street Address, City, State and Zip Code as well as Dorm Room/Room Number) * Polo Shirt Size * S M L XL Enrollment appointments are offered (choose 1) * Thursday, August 23rd at 3:00pm Friday, August 24th at 9:00am I have conflicts with all of these dates and will need an individual appointment (please make every effort to make one of the above appointments before selecting this option -Thank you.) Appointments will be held at 55 Whitney, Suite 450 (4th Floor), New Haven, CT. It is advised that you use the Audubon parking garage on Audubon Street. You will receive a confirmation email that states the documents you must bring with you to enroll. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
