Winter Open House Registration

Fill out the form below to register for our Winter Open House event.

Questions? Email

First Name *
Last Name *
Date of Birth (mm/dd/yyyy) *
Start Term *
Academic Program *
Student Type *
Campus Tour Options - Residence Hall Tours Pending Availability
Are you interested in learning more about how USciences can prepare you for medical school?
Number of Guests, not including yourself
Phone Number, Other
Phone Type
Street Address
Apt, Suite, Unit, etc.
Zip Code