Basic Information

First Name *

Last Name *

Coyote ID *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number (xxx) xxx-xxx *

Email Address (must be a valid address) *

How did you hear about us? *

By whom were you referred?

Which Student Program Area(s) interest you? (Select up to 3)

*

In which quarter are you interested in participating?

General Information

*

	Yes	No
Have you been granted work study?	Yes	No
Will you be living on campus?	Yes	No
Are you an international student?	Yes	No

Student Information

Class Standing

*

Current Major *

Expected Date of Graduation (YYYY/MM/DD) * +

Creative Samples (OPTIONAL)

We love to see your creative work. Use the optional fields below to reference URLs where we can see your work. Online Design Portfolios | YouTube Videos | Social Channels You Manage | Publications & Writing Samples | Etc.

Link to your creative work - type the URL here.

Résumé

Do you have any prior experience in the area(s) of interest? If so, please describe. *

Please attach a cover letter

Please attach a copy of your résumé *

Marketing Planning & Strategy	Media-Software Technology
Graphic Design	Creative Writing
Video Production	Social Media
Research and Analytics	Other Other

Freshman	Sophomore
Junior	Senior
Graduate	Other
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