Summer Visit Program

*Student Email Address (Visit confirmation will be sent to this address)

*Expected Entry Term

Type of Student

*Intended Major

*Student's First Name

Student's Preferred Name

*Last Name

*Birthdate

*Mailing Address

Country

Street

City

Region

Postal Code

*Home Phone

*Student Cell Phone

*May we send you text messages about visiting and your application?

Has a member of your family attended or graduated from Bradley?

Relatives That Have Attended Bradley. (You may select more than one by holding ctrl key)

Student Academic
Information

High School Name

College Name

Are You Interested in Pre-Med or Pre-Law?

Pre-Med

Pre-Law

Parent Information

*Number of Guests Attending (Not Including the Student)

Parent 1 Type

Parent 1 First Name

Parent 1 Last Name

Parent 1 Email Address

Parent 2 Type

Parent 2 First Name

Parent 2 Last

Parent 2 Email

Bradley will follow the State of Illinois and CDC recommendations.

I also understand that my image or likeness may be represented by Bradley University for use in social media, publications, web or other materials.