Request Information Form
Student Information
First Name 
Middle Name
Last Name 
Preferred Name 
Address 
City 
State 
Zip 
Home Phone  (xxx) xxx-xxxx
Cell Phone (xxx) xxx-xxxx
Email 
Gender 
Ethnicity
Birth Date  mm/dd/yyyy
Parent Information
Father's Name  
(Put N/A if not applicable)

Occupation 

Mother's Name  
(Put N/A if not applicable)

Occupation 

High School Information
High School 
City 
State 
Zip
Homeschool 
GPA
Graduation Year 
College Information
College/University (any attended)
City
State
Zip
Additional Information
Enrollment Term  ex. Fall 2010
Potential Major
Intercollegiate Athletic Interests
Church
Denomination
Additional Comments
Correct Entry Checker (Leave blank if you are a human)
 
 
 
 
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This form is intended for students who may be interested in attending Covenant College. After filling out this form, we will send you more information about Covenant as soon as possible.

Required fields are marked with an asterisk ().

We look forward to working with you as you begin your college search.


14049 Scenic Highway, Lookout Mountain, GA 30750 | 888.451.2683