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Please send me an Evening/Weekend/Online information packet.
First Name (required)
Middle Name
Last Name (required)
Maiden Name (if applicable)
Nickname (if applicable)
Address
City, State, Zip
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Home Phone
 		Work Phone
Cell Phone
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Date of Birth (MM/DD/YYYY)
Current employer
Have you requested literature or applied to St. Catherine University before? (required)

I'd like to begin college in of year
Please choose the program(s) you're interested in:

College for Applied and Continuing Learning major

College for Women majors



















Are there additional majors you would like to see offered in the Evening/Weekend/Online format?
How did you become aware of the Evening/Weekend/Online program at St. Catherine University? (check all that apply):






Where have you seen or heard ads for St. Kate's programs? (check all that apply)