Fall Discover Day

Please complete this form with the student’s information, even if a parent or guardian is assisting. This helps us ensure we gather accurate registration information.

Student's First Name*

Student's Preferred Name (Please do not include parent's name here.)

Only needed if students preferred name is different than their first name

Student's Last Name*

Birthdate*

Mobile Phone Number*

Missouri S&T’s communication plan includes text messages to the mobile number you provided above. If you wish to opt out of communications via text messages, please check here.

I do not wish to receive text messages

PLEASE NOTE: Confirmation materials are sent via email to both email addresses provided below.

Email Address*

Parent/Alternate Email Address

Mailing Address*

Country

Street

City

Region

Postal Code

Fall Discover Day

Missouri S&T Admissions Missouri University of Science and Technology