420 West Main St., Danville, VA 24541   |   Phone: (434) 791-5600   |   1-800-AVERETT        Visit Campus

Future Students | Current Students | Working Professionals | Alumni | Parents | Community/Media | Faculty/Staff | Sports Fans

Please complete the following form if you would like to register for one of our upcoming open houses or if you would like to make an appointment with your Admissions Counselor for an individual admissions visit and campus tour.

Electronic Mail Address:

Name:

Preferred Name:

Gender: M F

Street Address:

City: State or Province:

Zip or Country Code: Country:

Telephone - Home: Cell:

High School:

Year of H.S. Graduation:

I plan to enter Averett in [month] [year]

My academic /career interests are
(please list)

My extracurricular interests (sports, clubs, music, theatre, etc.) are
(please list)

I would like to have an admissions counselor call me concerning an
Admissions Interview and Campus Tour.



If you experience difficulty with this or any other Averett University online forms, please contact our Webmaster at (434) 791-5720 or email webmaster@averett.edu

Thank You!