College Information Request

Get in contact with your college of choice. Please note: ethnicity, gender, and disability information is strictly voluntary information and is not required to register with MRO.


Name	:
Graduation Year	:
Interested Major	:
School of Interest	:
May we contact you?	:
Address 1	:
Address 2	:
City	:
State	:
Zip Code	:
Phone Number	:
Email	:
How would you like to be contacted?	:	Phone Email Snail Mail
Ethnicity	:
Gender	:
Disability	:
Religion	:
GPA	:
SAT Score	:
ACT Score	:
Date of Birth	:
Interested in an out-of-state school?	:	Yes No
How did you hear about us?	:
If by a friend, who?	:

By submitting this form, you are stating you would like to be contacted by Minority Recruit.