|
Contact Information
(*Required Field) |
| *First Name: |
|
|
| Middle Initial: |
|
|
| *Last Name: |
|
|
| *Street Address 1: |
|
|
| Street Address 2: |
|
|
| *City: |
|
|
| *State: |
|
|
| *Zip/Postal Code: |
|
|
| *Country: |
|
|
| Telephone Number - Home: |
|
()
(area code) phone number
country code (if non-U.S. number)
|
| Employer: |
|
|
| Telephone Number - Work: |
|
()
(area code) phone number
country code (if non-U.S. number)
|
| *Email Address: |
|
|
| Personal Information |
| Gender: |
|
|
| Citizenship Status: |
|
|
| Age: |
|
|
| Additional Information |
* Which Program/Location are you interested in?
|
|
|
| GMAT Score (if taken): |
|
|
| Number of Years of full-time work Experience: |
|
|
| Undergraduate or Graduate GPA: |
|
|
| When do you plan to begin study: |
|
|
Were you referred by a UConn MBA students or UConn MBA alum?
If so, by whom? |
|
|
| If not, how did you hear about UConn's MBA Program? |
|
Newspaper Ad
Radio Ad
Train Ad
Billboard Ad
Internet Banner/Ad or Search
UConn Email Message
Employer/HR Office
Friend/Relative
Current UConn Student
Direct Mail
Google
Masslive.com
Hartford campus Jumbotron
Other:
|
| Additional Comments/Questions |
| If you have a question or a request that is not addressed above, please type in a brief message (less than 250 characters). An admissions representative will send you a response. |
|
|
