Request Information

Fields marked with * are required.

Student Type

What type of student will you be? *

Personal Information

Student's First Name *

Student's Preferred Name/Nickname (if different)

Student's Middle Name

Student's Last Name *

Student's Email Address *

Confirm Student's Email Address *

Birthdate *

**You have indicated you are less than 10 years old. Please be sure to check the year.

Mailing Address

Country

Street

City

Region

Postal Code

Do you want to receive text and telephone communications? *

Yes

No

Student's Cell Phone Number

Academic Information:

Entry Term
Select the semester you would start taking classes at FGCU

What is your academic program of interest?

What is your academic program of interest?
If you are not yet sure, select the Undecided option.