Date of Tour:

Campus

Group Tour or Individual Tour
(Group of Students)

First Name

Middle Name

Last Name

Date of Birth

Preferred Name/Nickname 

Parent/Guardian's Name(s)

Student Personal Email

Parent Email

Student Cell phone (please include area code)

Home/parent phone (if applicable)

Mailing Address

City

State

Zip Code

High School

Graduation Year

T-shirt size

Major or Interested are of study 

Best way to contact me

Are you interested in any of the following? 

What is most important to you? 

Do you have a friend that you would like to bring with you to MPCC? If so, tell us their full name and phone number and you and your friend could receive a $250 scholarship when you both enroll for classes!

Friend's Full Name

Friend's Phone Number (include area code)

Friend's Full Name

Friend's Phone Number (include area code)