Inquiry Form - Parents

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Parent/Guardian Information

Parent/Guardian First Name*

Parent/Guardian Last Name*

Parent/Guardian Email*

Parent/Guardian Relationship Type*

Student Information

Student First Name*

Student Last Name*

Email Address*

Birthdate*

A prospective...*

Admission Information

Prospective Entry Term*

Intended Major*

What school does your student attend? (Please begin typing and select from the drop-down menu.)*

Additional Contact Information

Mailing Address*

Country

Street

City

Region

Postal Code

Home Phone

Mobile Phone

Clicking the "Submit" button below constitutes your written consent to be called and/or texted by Merrimack or Merrimack's agent at the number(s) you provided, regarding furthering your education. You understand that these calls may be generated using an automated technology.

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Merrimack College

Inquiry Form - Parents

Sign up to stay in the loop about Merrimack deadlines, events, announcements and more!

**(* denotes required field)**

Merrimack College

Inquiry Form - Parents

Sign up to stay in the loop about Merrimack deadlines, events, announcements and more! (* denotes required field)

Sign up to stay in the loop about Merrimack deadlines, events, announcements and more!

**(* denotes required field)**