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Discover SUNY Bus Trip 2019: Registration Form

By completing this form you are registering to attend the Discover SUNY Bus Trip program to visit Clinton Community College. Space is limited and accepted students will be given priority. Confirmations will be mailed and emailed prior to the trip. Each student riding the bus must register separately. We are unable to accommodate family for this trip, students only. Join us for an overnight visit to experience campus life at Clinton Community College. All transportation, lodging and on campus meals will be provided. Your chaperoned trip will include the opportunity to tour our campus, meet faculty and participate in activities in the residence halls.

Thursday, April 11 & April 12

First Name *

Last Name *

PO Box or Street Address *

Apartment Number

City *

State *

Zip Code *

Gender *

Email Address *

Home Phone Number: (XXX) - XXX - XXXX *

Cell Phone Number: (XXX) - XXX - XXXX *

Text me updates and reminders (you may opt out at any time. Carrier fees may apply). *

Date of Birth: (MM/DD/YYYY) *

Do you know another student attending the Discover SUNY Bus Trip? Do you want to request them as your roommate? List First and Last Name

 I will bring money to purchase lunch en route to campus ($10)

 (Optional) I will participate in Open Gym activities with Men's/Women's Basketball Coaching Staff. I will bring gym clothes and sneakers.

How did you hear about this program? *

Expected Entrance Term: *