Prepare for Providence - Accessibility, Health, Academic & Counseling Services

Please enter all information carefully. Items marked with an asterisk (*) are required.

I will be entering as a:*

First Name*

Last Name*

Email Address*

Birthdate*

Mobile Phone*

May we text you?*

Yes

No

Mailing Address*

Country

Street

City

Region

Postal Code

Intended Major:*

Please enter your high school graduation year as YYYY:*

Submitting this request constitutes my consent to receive communications - including through phone calls, text messages, e-mails, faxes, and any other means - from or on behalf of the university and its affiliates, agents, employees, and representatives for any university purposes at the (wireless) phone number(s) and contact information I have provided and may provide in the future. The foregoing consent includes but is not limited to receipt of communications sent by an automatic telephone dialing system or using an artificial or prerecorded voice or other automated technologies. I agree to notify the university in writing if I change, drop, transfer, or otherwise surrender any phone number(s) or e-mail(s) provided.
By registering you "agree" to below, you:

Acknowledge that we have informed you that we will audio and video record this event, and each participant may be recorded.
Give us permissions to use the recording of you in any way and for any purpose, including marketing, promotional, educational, and other university purposes.

If you prefer not to be recorded, you must turn off your camera and microphone.