Prospective Undergraduate Student Request for Information

*Denotes a required field

Student Information

*Legal First or Given Name:

First Name:

How does Mines use my ‘Legal/given name’ and ‘first name’?

Mines will use your ‘Legal first/given name’ for all communications that include parents/guardians and on any mailed materials.
Your ‘My first name’ will be used in all email communications to you, on your applicant portal and will become a part of your email and username at Mines if you attend.
If you go by your Legal/given name, you may leave ‘first name’ blank and Mines will use your legal name in all communications.

*Last Name:

*Email Address:

*Phone Number:

*Birthdate:

Note: You are a first-generation student if you are the first in your family, other than siblings, to attend college.

*Will you be a first-generation college student?

*Anticipated Entry Term (when you would start at Mines):

*Are you a prospective:

Level of Study - College (Transfer)

Name of most recently attended college:

CEEB (Transfer)

Mailing Address

Country

Street

City

Region

Postal Code

Parent or Guardian Information

*Would you like to provide contact information for a parent or guardian?

Yes

No

*Parent/Guardian First Name:

*Parent/Guardian Last Name:

*Parent/Guardian Email Address:

Would you like to provide contact information for a second parent or guardian?

Yes

No

*Parent/Guardian First Name:

*Parent/Guardian Last Name:

*Parent/Guardian Email Address:

Educational Interest

*What major are you most interested in?

*I would like to opt-in to receive information and updates via text from Colorado School of Mines.

Yes

No

Disclaimer: By submitting this consent, you are providing your express written consent that Colorado School of Mines may, directly or through third-parties acting on its behalf, send marketing information regarding Colorado School of Mines and your continuing education, including texts, e-mail, and calls made using an automated dialing system to the number and email address that you provided above. Providing this consent is not required to obtain any good or service.