Campus Visit Request Form

We are excited for you to see Simpson College! Simply fill out the form below to schedule a campus visit. If you prefer, you may call us toll-free at 1-800-362-2454, locally at 515-961-1660 or email Debra Lord, our campus visit coordinator to make arrangements.

Which day would you like to visit? (Please note: Saturday, October 4th is Fall Visit Day, a group visit day only; October 16, 17 and 18 are Fall Break dates and no campus tours are offered.)
What time would you like to arrive?

Gender:	Male Female
First Name:
Last Name:
Street Address:
City:
State:
Zip:
Country:
Phone Number (Home):
Phone Number (Cell):
Email: *

High School:
Graduation Year:
GPA:
Class Rank:	out of
ACT/SAT I Score:
Academic Interests:
Other Interests:

Will your parents be joining you? Yes No
Please list their name(s): 1.
2.
3.
4.

Will anyone else be joining you? Yes No
Please list their name(s): 1.
2.
3.
4.

Would you like to meet any of the following?
1. Faculty:
- Subject Area:
2. Coach:
- Specify Sport:
3. Financial Aid:	Yes No

Notes/Comments: