College Night 2020 Registration
*College Night is taking place on March 12th from 6 - 8:30 pm at the Zane State College/Ohio University Zanesville Campus Center.

*Please complete one registration per student.

*If registering more than one student, be sure 'Total Number Attending' is accurate when both registrations are added together.

*For example, if two students and two parents will attend, each student's registration should have '2' as the 'Total Number Attending', counting one parent with each student registering.
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Student First Name *
Student Last Name *
Address *
City/Town *
State *
Zip Code *
Student Email Address *
Phone Number *
Date of Birth *
MM
/
DD
/
YYYY
Current Grade Level *
Name of Parent(s) or Guardian(s) *
Parent(s)/Guardian(s) Email Address
Total Number Attending *
School Currently Attending. If your school is not listed, select "Other" and write it in. If you attend Mid-East, select your home school as well. *
Required
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