Student Name*

Address*

City*

State*

Zip Code*

Phone Number

E-mail Address

Major

Education Majors Only:

Elementary Education
Secondary Education

Select your top two sessions:

Names of all parents/guests attending:

Total number of parents/guests attending:

During SWARM:
Accommodations needed for disabilities

* indicates a required field

The SWARM program cost is $50.00 per student which includes a new student folder, lunch, the student identification card, SWARM parking permit, and the enrollment processing fee. The first guest is $25.00, and each additional guest is $5.00.

You may also call us to pay by credit card, or make your check or money order payable to ESU, and mail to:

ESU Admissions, Box 4034
1200 Commercial St.
Emporia, KS 66801

If you sign up shortly before a SWARM program, you may bring your payment with you that day.

We look forward to seeing you at SWARM!