Company First Name * Last Name * Email * Address Line 1 * Address Line 2 City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP Code * Best phone number to reach you * Gender Birthday What high school/college do you currently attend? * Semester entering Francis Marion University * Late Spring 2017 Summer I 2017 Summer II 2017 Fall 2017 Spring 2018 Fall 2018 Other Academic Interest Which date would you like to attend? * October 14, 2017 November 11, 2017 December 9, 2017 February 3, 2018 March 3, 2018 April 7, 2018 Including yourself, how many people will attend? * Do you have any special needs related to disability? Special note: for any special needs, please make your reservation at least 1 month in advance for us to accommodate you the best!