Admissions Office
MSU-Northern
P.O. Box 7751
Havre, MT 59501-7751

(406) 265-3704 or
(800) 662-6132 x3704

admissions@msun.edu

Office Location:
Cowan Hall 213

Campus Visit Request Form
Items with an * are required

Please be aware that the information you about to submit will be sent via email. If you are not comfortable sending any of this information in this manner, please call us directly at (406) 265-3704 or (800) 662-6132 x3704, and we can make arrangements for your visit over the phone.

Student Information
First Name:	*
Middle Name:
Last Name:	*
Birth Date:	*	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Sponsor/Guardian:
Major(s) of Interest:

Contact Information
Address Line 1:	*
Address Line 2:
City:	*
State/Province (US/Canada):	*	Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick Newfoundland and Labrador New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon
Country: (if not US)
Zip/Postal Code:	*
E-mail:	*
Phone:	*	( ) -

Visit Date & Time
Daily visits are scheduled Monday through Friday with two start times - 9 a.m. or 1 p.m. The Admissions Office is open 8 a.m. to 5 p.m., Monday through Friday (summer hours are 7:30 a.m. to 4 p.m.)
Requested Visit Date:
Time of Arrival:		9:00 a.m. 1:00 p.m.
Date of Departure:

Accomodations
Room Type:		None Single Family
Handicap Access:		No Yes
Number of Guests:		0 1 2 3 4
Names:

Tour Information
# Taking the Tour:		0 1 2 3 4 5
Tour Guest Names:

I/We would like to see the following areas:
	Introduction	Financial Aid	Admissions
	Tour	Instructor	Athletics
	Housing	Student Services	Class Observation
	Other:
Please click the Submit button only once - Thank You!