Request Information

This form is intended for undergraduate prospective students. If you are interested in our graduate programs, the Graduate Programs in Education or Earlham School of Religion, please complete the Graduate Interest Form.

If you are a high school/independent counselor or work with students through a community based organization, please complete the Counselor Information Request form.

*required fields

First Name*

Preferred Name

Middle Name

Last Name*

Birthdate*

Gender

Email Address*

Mailing Address*

Country

Street

City

Region

Postal Code

Mobile Phone

May we text you?

Yes

No

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Home Phone

What type of applicant will you be?

Undergraduate First-Year

Undergraduate Transfer

High School Graduation Year*

When do you intend to enroll?*

High School*

College/University*

CEEB Code

What are your academic interests? (CTRL + click to select multiple)

What are you passionate about? (CTRL + click to select multiple)

Other Passion

What are your extracurricular interests? (CTRL + click to select multiple)

Are you interested in playing varsity sports in college?

Yes

No

If you would like more information on Earlham Athletics please complete the Recruiting Questionnaire

Parent Information (Optional)

Parent Type

First Name

Last Name

Email

Is your parent/guardian an Earlham Alumni?

Yes

No

What year did your parent/guardian graduate from Earlham (yyyy)

Questions about how Earlham uses your information? See our Privacy Policy.

Specialized Info

Utility Links

Request Information

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