Fall Discover Day

First Name*

Middle Name

Last Name*

T-Shirt Size:*

If you have more than one student interested in Missouri S&T, please complete a separate registration form for each.

Birthdate*

Gender*

Female

Male

Ethnicity

Hispanic

Yes

Contact Info

Mailing Address*

Country

Street

City

Region

Postal Code

Phone Number*

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*

Confirm Email Address*

Parent/Alternate Email Address

Fall Discover Day

Missouri University of Science and Technology

#MINERPRIDE