Request for Information - Undergraduate Students

Complete the information form below in order to receive information on our academic programs, upcoming events, visit opportunities, and more! Be sure to add admissions@fitchburgstate.edu and fitchburgstate@fitchburgstate.edu to your address book.

Personal Information

First Name:

Middle Name:

Last Name:

Birthdate:

Mailing Address

Country

Street

City

Region

Postal Code

Email:

Cell Phone Number:

I authorize text messages to the mobile telephone number above and accept responsibility for any charges incurred.

Yes

No

Academic Information:

I plan on enrolling as a:

Freshmen

Transfer

When do you plan on entering Fitchburg State?

What High School do you or did you attend?

High School CEEB Code

High School Graduation Year

What is the current/most recent college you attend/attended?

College CEEB Code

I wish to learn about:

Day Classes

Evening/Hybrid Classes

Online Undergraduate Classes

What are your academic interests? Select all that apply.

Sport Interest

Parent Information

Parent First Name

Parent Last Name

Parent Email Address

HIDDEN: Relation type = Parent/Guardian

By submitting this form, I am providing my digital signature agreeing that Fitchburg State University may email me or contact me regarding educational services by telephone and/or text message utilizing automated technology or a pre-recorded message at the telephone number(s) provided above. I understand this consent is not a condition to attend Fitchburg State or to purchase any other goods or services.

aca level - ug

Undergraduate Student