Alumni Student Referral Form

Please send us the names of any student you think will be interested in attending EKU.

Prospective Student Information

Prospective Student Name *

Prospective Student Mailing Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

Prospective Student Phone Number *

Prospective Student Email Address *

Alumni InformationPlease provide your information so that we can follow up with you about the student prospect.

Relationship to Prospective Student *

Your Name *

Your Phone Number *

Your Email Address *

Street Address

Apartment, suite, etc

City

State/Province *

ZIP / Postal Code

Country

EKU Graduation Year

Why are you recommending this student? *