Prospect Inquiry

Thank you for your interest in Life University!

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Demographic Information

First Name (Legal)

Middle

Last Name (Legal)

Email Address

Confirm Email Address

Cell Phone

Home Phone

Date of Birth

Please format Date of Birth as MM/DD/YYYY

Which of the following best describes you?

Check here if address outside the U.S. or Canada

Street Address

Apt/Suite

City

State/Province

ZIP/Postal Code

Country

Mailed Communications Preferred

Would you like Life University to physically mail you some communications (if available) instead of emailing them? If you do not provide a response, an answer of "no" will be recorded.

Academic Interests

Anticipated Academic Level

Anticipated Academic Program

Location

Anticipated Entry Quarter

How did you learn about LIFE U?