Panther Days

Panther Days

Registrant Information

First Name

Last Name

Gender

Student Email

Verify Email

Birthdate (mm/dd/yyyy)

Student Mobile Phone

Street Address

City

State or Province

Zip Code

Please inform us any special needs or medical issues

Education Information

Anticipated York College Start Term

Anticipated York College Start Year

Anticipated Academic Program

I will be entering college as a

If you are currently in high school, you would be entering college as a Freshman

What school do you currently attend? Choose Unknown School if no match

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Phone Number

Is the parent/guardian listed also your emergency contact?

YesNo

Emergency Contact Name

Emergency Contact Phone Number

Interests

Sport of Interest

Performing Arts Activity

How did you hear about Panther Days?

Admissions Recruiter	Current York College Student
Email	Facebook
Friend	Instagram
My Church	Parent
Postcard	Twitter
York College Website

Check all that apply

Contact Information