Form for referring a student

Concordia University
Office of admission referral form

Do you know a high school student who might be a good fit for Concordia University, Nebraska? Help continue the Concordia Legacy by completing this referral form to recommend family members, friends or outstanding students in your congregation and community. For multiple referrals, you can resubmit this form as many times as you like.

Please fill out the following form and select the SUBMIT button at the bottom of the page to send the information to an admission counselor at Concordia.

Please indicate your relationship with the person whose information you are supplying:

Parent Grandparent Other relative Friend

Thank you for the referral!

Prospective student's last name

Prospective student's first name

Street

City

State

Zip

Phone

Best time to call prospective student?

E-mail

This e-mail address is

This student's gender
Male Female

Select this student's current or last class year:

Select the year this student would enter Concordia

Last high school this student attended

City (of high school)

High school graduation year

Last college this student attended

City (of college)

Religious affiliation

If "other" selected

Please mark the checkbox near any of the following interest areas that this student might want to pursue at Concordia.
Extracurricular Interest Intramurals Cheerleading Drill Team Yearbook Newspaper Fell of Christian Athl Student Government Drama Forensics Vocal Music Instrumental Music Worship Committee Clowns for Christ Sports Interest Football (M) Baseball (M) Golf (M/W) Tennis (M/W) Basketball (M/W) Track (M/W) Cross Country (M/W) Soccer (M/W) Softball (W) Volleyball (W)	Subject Interest Art Biology Business Speech Drama Chemistry Communications Computer Science Early Childhood Ed English Geography Health and Phys Ed History Math Medicine Music Physics Psychology Science Special Ed Sociology Spanish Theology	Career Interest Art Business Dir of Christian Ed Law Medicine Nursing Pharmacy Dentistry Med Tech Physical Therapy Pastor Social Work Teacher

Any questions or comments?

Concordia University, Nebraska
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800 N. Columbia Ave. Seward, NE 68434

800-535-5494

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Form for referring a student

Concordia University Office of admission referral form

Concordia University
Office of admission referral form