Registration Form-Please Print and Return to Address Below

Please complete this form using pen and your clearest handwriting.

(Mr./Ms.) __________________________________________

                        Last                             First                            MI

Social Security Number ______________________________

Name you would like on your nametag ________________

____________________________________________________

Street Address

____________________________________________________

City                                         State                            Zip

(______)_____________________

Telephone number

Email Address:______________________________________

Session Dates

Place a 1 beside your first choice and a 2 beside your second choice.  We will make every effort to accommodate your preferences, but sessions fill up fast, so register early.  Remember, you MUST register in order to attend orientation. 

 ____June 11-12                                  ____July 16-17

 ____June 25-26                                  ____August 6

 ____August 24 (reserved for out-of-state students)

Fees

You must pay your Matriculation Deposit through the Admissions Office (843-661-1231) BEFORE you can register for orientation.  The Matriculation Deposit covers the cost of your orientation program and allows you to bring one guest.

 If you have paid your Matriculation Deposit, please check any additional orientation fees that are appropriate to you:

____Overnight fee……………………………………………$25

            (required if student is spending the night on campus)

____Additional Guest fee…………………………………...$30

            (remember, one guest is already included)

            Total                                                                    $_________

Name(s) for Guest Name Tags

Guest #1________________________________________________

Guest #2________________________________________________

Payment options (please check one)

___Check                    ___Money Order

___Visa                       ___MasterCard                      ___Discover

Name on card:____________________________________________

Account number of card:___________________________________

Expiration date:___________________________________________

Total charged:____________________________________________

Cardholder signature:_____________________________________

Please return this form as soon as possible with your additional fee payment (if necessary) to:

                        Francis Marion University

                        Cashier’s Office

                        P.O. Box 100547

                        Florence, SC  29502-0547

Please make checks payable to Francis Marion University.