College of Pharmacy Student Chat (Virtual)

We're pleased you're interested in attending our virtual event! Please fill out the form below to register.

*denotes required field

Are you a...

Prospective Student

College/School Counselor

Family Member/Supporter

Other

Please specify:

Guest Information

Guest First Name

Guest Last Name

Guest Email

Guest School or Organization

Guest Job Title

Student Information

Student's First Name*

Student's Preferred Name

Student's Last Name*

Student's Email Address*

Confirm Student's Email*

If you would like a copy of your confirmation email sent to a parent/guardian,
please enter that email address below.

I would like to receive text messages:

Yes

No

Student Mobile Number

U.S. armed forces status

Have you submitted an application for admission to The University of Rhode Island?*

Yes

No

Are you connected with a Community Based Organization? (i.e. Upward Bound, TRIO, KIPP)

Would you like to provide or update your address?

Yes

No

Student Mailing Address

Country

Street

City

Region

Postal Code

Would you like to us a little more about yourself?

Yes

No

Student Gender

Prefer to self-describe:

Student Academic Information

I am a*

First-year student

Transfer Student

I plan to enroll*

I plan to live on campus*

Yes

No

I plan to major in*

Current High School*

High School Address

Country

Street

City

Region

Postal Code

What are you hoping to get out of this session?

Are you connected with a Community Based Organization? (i.e. Upward Bound, TRIO, KIPP)

Most recent institution*

Most Recent Institution Address

Country

Street

City

Region

Postal Code

What are you hoping to get out of this session?

Family Member/Supporter Information

Relationship to Prospective Student: *

List other relationship type. *

Family Member/Supporter First Name *

Family Member/Supporter Last Name *

Family Member/Supporter Mobile Phone *

I would like to receive text messages from URI *

Yes

No

Family Member/Supporter Email Address *

Where are you from?

Student First Name*

Student Last Name*

Student Email*

What questions do you have or what are you hoping to gain out of this session?