Alumni Student Referral Form

Please send us the names of any student you think will be interested in attending EKU.

Student’s Grade Level:

8th Grade

9th Grade

10th Grade

11th Grade

12th Grade

Transfer Student

Prospective Student’s First Name: *

Prospective Student’s Last Name: *

Prospective Student’s Gender: *

Female

Male

Prospective Student’s Mailing Address: *

City: *

State: *

Zip Code: *

Prospective Student’s Phone Number:

Prospective Student’s Email Address :

Please provide your information so that we can follow up with you about the student prospect.

Relationship to Prospective Student:

Family Friend

Parent

Grandparent

Educator

Other

Your First Name: *

Your Last Name: *

Your City:

Your State: *

Graduation Year from EKU:

Your Phone Number: *

Your Email:

I am recommending this student because:

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Alumni Student Referral Form

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