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Personal Information

First Name

Last Name

Birthdate

Are you a U.S. military veteran, a service member, or a dependent child or spouse of a veteran or service member?

Contact Information

Email Address

Cell Phone Number

Are you willing to accept text messages from Xavier University?

Yes

No

Parent/Family Email Address 1

Parent/Family Email Address 2

Address

Mailing Address

Country

Street

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Region

Postal Code

Academic Information

Which student type best describes you?

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Are you a U.S. Permanent Resident?

Yes

No

When do you plan to enroll in college?

Academic Interest

High School

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