Personal Information

First Name *

Middle Name *

Last Name *

Date of Birth * January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Sex * Male Female

Enrollment Term Beginning * Fall Spring Summer 2007 2008 2009 2010

HSU-ID Number:
Enter only numbers - no punctuation.

Contact Information

Name of Parent/Guardian *

Your Home Phone Number *
Enter only numbers - no punctuation.

Your Email Address

Street Address *

City *

State *

Zip *

Country *

Room Survey

Your class standing when you arrive on campus *
Freshman Sophomore Junior Senior Graduate Other

If "other" please describe.

Are you currently living on the Humboldt State campus? *
Yes No

Have you previously lived on the Humboldt State campus? *
Yes No

Have you attended Humboldt State before? *
Yes No

Questions

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