Montana State University-Northern
Future Students
Information Request Form
Items with an * are required.

Please be aware that the information you about to submit will be sent via email. If you are not comfortable sending any of this information in this manner, please call us directly at (406) 265-3704 or (800) 662-6132 x3704, and we can get the information mailed out to you.

 
Student Information
First Name: *
Middle Name:  
Last Name: *
Birth Date: *
 
Contact Information
Address Line 1: *
Address Line 2:
City: *
State/Province
(US/Canada):
*
Country:
(if not US)
Zip/Postal Code: *
E-mail: *
Phone (Cell): ( ) -
Phone (Home):   ( ) -
Contact Preference:  
 
Academic History
High School: * Graduation Year:
Prior College:  
 
Admission
Term Attending: * *
Year Attending:
Major: *
 
How did you hear about MSU-Northern?
  High School Visit College Fair Website
  Friend Parent Counselor
  Other:
 
 
 
Please click the Submit button only once - Thank You!