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Required fields are marked with an asterisk(*).

Student Information

First Name*

Preferred First Name

Last Name*

Date of Birth*

Email Address*

Preferred Phone Number*

If this is a cell phone number, would you like to receive confirmation details by text?

Yes

No

Mailing Address*

Country

Street

City

Region

Postal Code

Do you plan to enroll in college fresh out of high school, or are you transferring from another institution?*

What is the name of your high school?*

What is your high school's CEEB code?

When do you plan to start college?*

What is the name of the college/university you most recently attended?*

What is your school's CEEB code?

When do you plan to start at Northland?*

Additional Questions

Would you like us to send visit confirmation details to one of your parents or a guardian?

Yes

No

First and Last Name (parent or guardian)

Email (parent or guardian)

Phone (parent or guardian)

What is their relationship to you?

Do you have time to answer a few more questions?

Yes

No

How does Northland compare to the other colleges you're considering?

It's is my top choice

It's my second choice.

It's my third choice (or below).

Are you interested in playing a varsity sport?

Yes

No

What are some of your extra-curricular interests?

What do you already know about Northland College?

What would you like to know more about?