Saturdays @ SAM
Mail to: Sam Houston State University
John R. Ragsdale Visitor and Alumni Center
Box 2539
Huntsville TX 77341-2539

Name_________________________________________

Address________________________________________

 City______________________State____Zip__________

Telephone (_____)___________________________ ____

E-mail Address _____________________________ ____

(confirmation # will be sent to this e-mail address)

Number of Additional Guests _______________________

(not including self)

How did you hear about SHSU?_______________________________________________

How did you hear about Saturdays @ SAM?___________________________ __________

Do you have any special needs? If so, explain.

_______________________________________________________________  ________

School Now Attending____________________________

Academic Interest______________________________ _

Saturdays @ SAM Session Attending     _____________________________

Current Status

___High School Senior   ___High School Junior
___College Transfer       ___Other