Lock Haven University of Pennsylvania

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 Date of Birth
  		Sex
Male    Female 		Today's Date
 
 Last Name
  		First Name
  		Middle Name
 
 
 Street Address
  		City/Town
 
 
 State
  		 Zip Code 
  		 County 
  		Country
 
 
Email
  @ . (example: jsmith@hotmail.com)
 
 Phone
  		Major
  (visit the Academics page for a listing of majors)
 
 Are You a High School Student?   
  Yes    No 		Name of High School
 Graduation (month/year) 
 
 Are You a Transfer Student?   
  Yes    No 		Name of College Attended
 Sem. & Year to Enter LHU
 
  Ethnic Background (optional)
  Black/ African American   American Indian or Alaskan Native  
  White/ Caucasian   Asian/Pacific Islander   Hispanic/Latino
 
 
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