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Campus Status: COVID-19 Status Updates
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Who Needs to Complete This Form
Due to COVID-19 we are taking precautions for the health and safety of students, faculty, and staff. Prospective students may visit our campuses by appointment. Visitors must answer screening questions and wear masks. Complete the form below if you wish to tour a particular program or meet with an instructor. We will contact you to confirm your date and time. If you have questions about admissions please call the Whiteville campus at 731-254-8521 or 731-772-8160 for the Brownsville extension campus
First Name
Last Name
Date of Birth
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High School Graduation Date
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Month
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Program Interests
Automotive Technology
Computer Information Technology
Health Information Management Technology
Heating, Ventilation, Air Conditioning/Refrigeration
Industrial Maintenance Technology
Machine Tool Technology
Patient Care Technician / Medical Assistant
Practical Nursing
Welding Technology
Your Contact Info
Email Address
Phone
Phone (Mobile)
Address
Address 2
City
State
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
About Your High School
High School Name
High School City
About Your Visit
Date You'd Like to Visit
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
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Nov
Dec
Day
Day
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Year
Year
2021
2022
Please note: Campus tours are typically Monday-Friday, 8am to 4:30pm by appointment. Your tour time/date will be confirmed before it is scheduled.
How many guests will you bring?
- None -
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