First Name:

Last Name:

Address:

City: State: Zip:

Phone Number:

Email:

Intended Major at PNC:

I will be a (choose one):

Full-Time Student (taking 12 or more credit hours; four or more classes)

Part-Time Student (taking 11 or fewer credit hours; less than four classes)

I prefer to enroll in:

AM Classes

PM Classes

Days/times I cannot attend classes:

Beginning students admitted for Summer or Fall 2013 choose ONE of the following Orientation dates:

June 1, 8:30 a.m.-12:30 p.m.

June 7, 8:30 a.m.-12:30 p.m.

I will have the following number of guests with me:

New Student Orientation begins in the Technology Building, North Lobby.