UM Alumni Referral Form

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Some content may be updated based on selection

Please fill out the form below with as much information as you can provide. Contact the Office of Admissions at admissions@montevallo.edu or 205-665-6030 if you have any questions. Thank you!

Your Name

Your Phone Number

Your Email

Your Class Year

Student's First Name

e.g. xxxxxxxxxxxxxxxxxxx

Student's Last Name

e.g. xxxxxxxxxxxxxxxxxxx

Student's Gender

Student's Address

City

e.g. xxxxxxxxxxxxxxxxxxx

State

e.g. xxxxxxxxxxxxxxxxxxx

Zip Code

e.g. 9999999999

Student's Email

Student's Phone Number

e.g. (999) 999-9999

Student's Intended Major

e.g. xxxxxxxxxxxxxxxxxxx

Student's Current High School or College

Student's High School or College Graduation Year

Additional Areas of Interest (ex Athletics, Study Abroad, Student LIfe)

Please provide any additional information you would like to share about the student.

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