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Application Management

Build Your Bright Future

Saturday, September 19, 2026 at 8:30 AM until 2:00 PMEastern Daylight Time UTC -04:00

Charles B. Degenstein Campus Center
Susquehanna University
Selinsgrove, PA 17870
United States

Student Information

Student's First Name *

Student's Preferred First Name (name you would like on your name tag if not your first name)

Student's Last Name *

Preferred pronouns to appear on name tag (optional)

Student's Birthdate *

Mailing Address *

Country

Street

City

Region

Postal Code

Email Address *

Home Phone

Cell Phone *

Academic Information

Current School *

I am a prospective *

College Entry Year *

Intended Major*

Parent/Guardian Information

Relationship*

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian E-mail Address *

Parent/Guardian Mobile Number *

Have you had a parent or grandparent graduate from Susquehanna?*

Yes

Please enter the name(s) and grad. year(s) of your alumni relatives below:

Will any of these relatives be joining you for the event?

Yes

Visit Information

Number of Guests (not including the student)*

Special Accommodations (Food Allergies, Accessibility, etc)