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. This includes a new student folder, lunch, the student identification card, SWARM parking permit, and the enrollment processing fee.

Would you like to have your SWARM fees added to your tuition billing later? No Yes

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!