Preview Day Registration

Name and Contact Information

Student First Name

Student Last Name

Student Preferred First Name (if different)

Student Date of Birth

MM/DD/YYYY

Student Mobile Phone

You will receive text messaging relating to your visit.

Home Phone

Student Email

Verify Email

Street Address

City

State or Province

Zip/Postal Code

Would you like to provide parent/guardian information to include them in university communication?

YesNo

Special Needs/Requests:

Your day includes a student-led, walking tour of campus . Please indicate if you will require special assistance. We will accommodate if resources allow.

Privacy Statement

All personal data and special categories of sensitive personal data collected or processed by Georgia Southwestern State University must comply with the University System of Georgia’s (USG) Cybersecurity Plan, as authorized by the Board of Regents Policy Manual Section 10.4 Cybersecurity: www.usg.edu/policies. Anyone suspecting their sensitive personal data has been exposed to unauthorized access, report your suspicion to techsupp@gsw.edu. Otherwise, questions concerning general data privacy can be sent to dataprivacy@gsw.edu. Clicking the checkbox (left) and submission of this form provides consent to and acknowledgement of the USG Data Privacy and Legal Notice and relative policies.

Mother	Father	Grandparent
Aunt/Uncle	Sibling	Other

Mother	Father	Grandparent
Aunt/Uncle	Sibling	Other

GSW Mailed Postcard	GSW Email	GSW Text Message
Google Search	GSW Website Visit/Pop-Up	Internet Ad on Other Website
Instagram/Facebook	Phone Call from GSW	Friend/Family
High School Counselor	College Fair	GSW Rep at High School