Undergraduate Request for Information

First Name *

Last Name *

Birthdate *

Email Address *

Mailing Address *

Country

Street

City

Region

Postal Code

Mobile Phone

Please enter your current or most recent school or institution

Please select the level of the high school or college listed above

Select High School for all High School Information

Select Undergraduate for College Information

Select Graduate for College Information Masters Degree and Above

Would you like to receive text messages from South?

Yes

Are you a US Citizen?

U.S Primary Citizenship

Primary Citizenship

Secondary Citizenship

Permanent Resident?

Yes

Please select your student type

Please select you student type

Please indicate your desired primary academic program

Please indicate your secondary academic program interest, if applicable.

Please indicate your tertiary academic program interest, if applicable.

Please indicate your desired entry term

How did you hear about us?

Other?

If your parents would also like to receive information about South Alabama, you can provide their name and email address below.

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email Address