1.	First name:*

2.	Last name:*

3.	Email address:*

4.	Preferred telephone number:*

5.	Mailing address:

6.	City, State and Zip code:

7.	I would like more information about (choose one degree program):*
	--Please Select--Bachelor of Arts, Administrative LeadershipBachelor of Arts, Informational Studies (online only)Bachelor of Arts, Liberal Studies (online only)Bachelor of Arts or Science, Multidisciplinary StudiesBachelor of Science, Criminal JusticeBachelor of Science in Education, Early Childhood EducationBachelor of Science in Nursing, Accelerated BSNBachelor of Science in Nursing, Traditional BSNBachelor of Science in Nursing, LPN-BSNBachelor of Science in Nursing, RN-BSNBachelor of Science in Medical Imaging and Radiation Sciences, RadiographyBachelor of Science in Medical Imaging and Radiation Sciences, SonographyMaster of Arts, Administrative Leadership (online only)Master of Arts, Liberal Studies (online only)Master of Arts, Organizational DynamicsM.Ed. in Educational Administration, Curriculum and SupervisionMaster of Science, NursingMaster of Occupational TherapyMaster of Public HealthMaster of Health Science, Physician Assistant StudiesMaster of Architecture, Urban StudiesMaster of Science, Architectural Urban DesignMaster of Human RelationsMaster of Library and Informational StudiesMaster of Public AdministrationMaster of Social WorkMaster of Science, Electrical and Computer EngineeringMaster of Science, Telecommunications EngineeringEd.D in Educational Administration, Curriculum and SupervisionDoctor of PharmacyDoctor of Physical TherapySchool of Community MedicineKodaly Music CertificateOther

8.	If Other, please state your interest here:

9.	Please select any other program of interest:
	--None--Bachelor of Science in Nursing, AcceleratedMaster of ArchitectureMaster of Science in Architectural Urban StudiesBachelor of Arts, Multidisciplinary StudiesBachelor of Arts in Administrative LeadershipBachelor of Arts in Liberal StudiesBachelor of Science, Multidisciplinary StudiesBachelor of Science Nursing, TraditionalBachelor of Science in Nursing, TCC collaborative programBachelor of Science in Radiologic Technology, RadiographyBachelor of Science in Radiologic Technology, SonographyDoctor of Physical TherapyBachelor of Science, Early Childhood EducationDoctor of Education, Educational AdminstrationBachelor of Science in Nursing, LPN career mobilityMaster of Education, Educational AdministrationMaster of Human RelationsMaster of Library and Information StudiesMaster of Occupational TherapyMaster of Public AdministrationMaster of Public HealthMaster of Science in Electrical and Computer EngineeringMaster of Science, Nursing EducationMaster of Science in Nursing, Nurse PractitionerMaster of Social WorkMaster of Arts in Organizational DynamicsUndecided-Send viewbookMaster of Science in Physician Assistant StudiesDoctor of PharmacyDoctor of Philosophy, EngineeringDoctor of Philosophy, Electrical and Computer EngineeringBachelor of Science in Nursing, RN career mobilityMaster of Science in Telecommunications Engineeringnonenone

10.	Additional questions or comments:

11.	How did you hear about OU-Tulsa and our programs?*
	Alumni Referral    Billboard    College of Continuing Education    Current Student Referral    Direct Mail    Education Fair or Career Fair (please answer question 12)    Faculty/Staff Referral    Television Ad    Word-of-mouth    Radio Advertisement    TCC Advisor    Tulsa World    TV Advertisement    Urban Tulsa Weekly    Web Search    OU representative at TCC    Other, please specify

12.	What Education Fair Did You Attend?

13.	Intended start semester:*
	--Please Select--Spring 2011Summer 2011Fall 2011Spring 2012Summer 2012Fall 2012Spring 2013

14.	Source of Inquiry