Initial Questionnaire

Fill out and submit our initial questionnaire to begin your LACROSSETHEPOND experience.

Personal details
Name*
First Last
Date of Birth*
DD slash MM slash YYYY
Contact details
Email*
Mobile phone*
Home phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Education information
School name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Degree Classification*
- Bachelor of Arts
- Bachelor of Science
- Other
Major*
Minor (if applicable)
G.P.A (expected if not yet graduated)*
Year graduated*
What field are you looking to pursue your post-graduate education in*
(You can provide multiple areas of study if undecided, and we will recommend the best school for each individual field)
Your Experience
Where did you hear about LACROSSE THE POND?
If selected other, Please specify here.*
What are you looking to gain from your LACROSSE THE POND experience?
Do you have any initial ideas to what sort city or environment you would like to live in?
Are you happy to be added to the mailing list for updates?
- Yes

Personal details