Homecoming Legacy Event:
Senior Reception

High School Seniors
Saturday, October 22, 2011
8:30 a.m.- 9:45 a.m.
Walls Lounge, Elaine Langone Center, 2nd Floor

Limited to high school seniors and their families, this event is an opportunity to meet with Admissions staff members for informal conversations and to participate in a question and answer session with a student panel. A buffet-style continental breakfast will be served.

Please complete the following form to register for the Senior Reception event during Homecoming Weekend. * Note: All fields are REQUIRED.

Alumni Information

First Name(s):

Family Last Name:

Maiden Name (if applicable):

Bucknell Class of:

What is your relationship to the prospective student?

Please indicate any other Bucknell connections to the prospective student:

Sister Brother Stepsibling

Mother Father Stepparent

Grandmother Grandfather Stepgrandparent

Prospective Student Information

First Name:

Last Name:

Gender:

Female Male

Address:

City:

State:

Zip:

Country:

Home Phone Number:

( ) -

Cell Phone Number:

( ) -

Birth Date:

Day:

Year:

Email:

High School:

High School City and State:

High School Graduation Year:

Total Number Attending
Senior Legacy Reception: