To:

From:

Name:

E-mail:

Note:
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Address

City, State, Zip

,

Home Phone

Date/Year of Graduation

High School

Interest in UMES

Very Strong
Somewhat Strong
Uncertain
Not Interested

Academic Major Interest(s)

Extracurricular Activities

Do you plan on visiting UMES?

Yes
No

Would you like to discuss your eligibility for a scholarship?

Yes
No

GPA

ACT

SAT

Financing for education is:

A Major Concern
Somewhat a Concern
Not a Concern

Do you plan to apply for financial aid?

Yes
No

Please let us know of any specific needs or concerns: