Visit Vox Registration Form

Date of Visit Vox

Please select which Visit Vox date you wish to attend. If one of these dates does NOT work for you, please select "Other" and in the "Questions, Concerns, Comments" box at the bottom of this form, tell us when you'd like to visit.

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender:

Male

Female

Birthdate

MM

DD

YYYY

School Currently Attending (if applicable)?

What year did / will you graduate high school?

Parent / Guardian Name(s)

Parent / Guardian Phone Number

(###)

###

####

Total number of people attending Visit Vox with you (Including yourself)?

Will you need overnight accommodations at Look Up Lodge?

Vox is happy to cover this cost for visiting students and their families.

Yes

No

Do you have any dietary restrictions?

If so, please list them in the field below so we can accommodate for the meals we provide during Visit Vox Days.

Questions, Concerns, Comments?