Student Information

W&J Student Matriculation Information Form

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Student Information

The following information will be used for our campus records and will be kept on file in the Office of Student Life. If you have any questions or would like to change any of your contact information at a later date, contact W&J's Office of Student Life at 724-223-1360 or studentlife@washjeff.edu.

1.	Student's Full Name* Last Name, First Name MI

2.	Student's Nickname (Optional)

3.	W&J ID NUMBER (This can be found on the welcome letter you received from the Admission Office after you paid your deposit to the College.)*

4.	Home Address*

5.	Home Phone*

6.	Student's Cell Phone*

7.	Student's Email*

8.	High School Attended* Name, City, State