In Person Campus Visit Registration Form

In Person Campus Visit Registration Form
Name
First NameLast Name
Date of Birth
MonthDayYear
Date
Gender
MaleFemale
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Position/Title
Current School Name
What is your Preferred Course?
Please select an available slot to schedule an In Person Campus Visit.
Purpose or reason for the visit
Date and Time In
MonthDayYear
Date
Hour MinutesAM/PM Option
Name of host or person you're visiting to
Email Address of the host or contact person
example@example.com
Phone Number of the host or contact person
Please enter a valid phone number.
Are you going to bring some guest?
YesNo
Please take note that there's a limit on the number of persons allowed to take a tour or visit the campus.
Guest 1
Guest 1 Name
First NameLast Name
Guest 1 Phone Number
Please enter a valid phone number.
Guest 1 Email
example@example.com
Guest 2
Guest 2 Name
First NameLast Name
Guest 2 Phone Number
Please enter a valid phone number.
Guest 2 Email
example@example.com
Have you been exposed to someone who is diagnosed with COVID-19?
YesNo
Are you experiencing any COVID-19 symptoms in the last 14 days?
YesNo
Did you travel from a place, city, or country where there are a lot of COVID-19 cases from the last 14 days?
YesNo
Do you have any comments, suggestions, or feedback?
Signature
Clear
Date Signed
MonthDayYear
Date
Should be Empty:

Guest 1