Physics Student for a Day Form

First, Last Name:
E-mail address
Parent(s)/Guardian Name

Street Address
City, State, Zip
Day you would attend
(8:30 AM - 5:30 PM):
Oct 12, 2018 (Fri)
Oct 15, 2018 (Mon)
Nov 9, 2018 (Fri)
Nov 12, 2018 (Mon)
Apr 5, 2019 (Fri)
Apr 8, 2019 (Mon)
Apr 15, 2019 (Mon)
Apr 19, 2019 (Fri)
High School
High School Graduation Date
(Month, Year)
Physics teacher's name
Guidance Counselor's name
What term will you first enroll as a student at Virginia Tech? FALL SPRING SUMMER
Which program are you interested in? Bachelor of Science in Physics
Bachelor of Arts in Physics
Bachelor of Arts with Teacher Education Option
Bachelor of Arts Pre Health Option
Bachelor of Arts Pre Law Option
Astronomy Minor
Biophysics Minor
Would you like to attend an Honors College information session? Yes
Other Comments/Questions: