Request Information Name * First Last Email Address * Home or Primary Phone * ### ### #### Mobile or Secondary Phone ### ### #### Birthday MM DD YYYY Address Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country Applying as a: First Year Student Transfer Student Anticipated Semester of Entry Fall 2012 Spring 2013 Fall 2013 Spring 2014 Primary Academic Interest Athletic or Club Interest Current School How did you hear about Notre Dame of Maryland University? Radio Facebook ad Athletics/Coach referral Church Friend/Student Faculty/Staff Alumnae Print ad Other If 'other', please elaborate: Additional comments Security Code Please enter the security code below.