Lock Haven University of Pennsylvania

request information

If you would like to have your name added to our mailing list, please fill in the information below and click on the send button.

Please allow several weeks for information to arrive.

Today's date

Student's date of birth

Male Female

First name   Last name  Middle name

E-mail address

Social security number (optional)

Are you a high school student?
Yes No

Name of high school   Year of high school graduation

Are you a transfer student?
Yes No

Name of college(s) attended:

Intended major  (see the Academic page for a list of majors)

Street address     City

State   Zip   Phone

Ethnic Background (optional) :
Hispanic/Latino Not Hispanic/Latino

Race (optional) :
American Indian/Alaskan Native
Black/African American
Native Hawaiian/Pacific Islander

You must click on the “submit” button below to process your registration.