Information Request Form
  1. I would like to know more about ENMU-Roswell!

    Note: If you have any problems filling out or submitting the form please contact New Student Relations at (575) 624-7168 or e-mail to nsr@roswell.enmu.edu

  2. Your First Name:(*)
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  3. Your Last Name:(*)
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  4. Your Birthday:
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  5. Your E-mail Address:(*)
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  6. Street or PO Box:(*)
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  7. City:(*)
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  8. State:(*)
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  9. Zip Code:
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  10. Daytime Phone:(*)
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  11. Evening Phone:
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  12. Academic Intent:
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  13. What is the name of the last high school or home school attended?:(*)
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  14. Have you received a high school diploma?:
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  15. Have you received a home school diploma?:
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  16. Have you received a GED diploma?:
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  17. What is the date of your graduation?:
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  18. If you received a GED, what was the state you tested in?:
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  19. If you received a GED, what is the last grade you attended?:
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  20. Beginning with the most recent, list all colleges, universities and technical/vocational schools you have previously attended. This includes attendance at any of the ENMU campuses.
  21. School Name:
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  22. Attended From:
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  23. Attended To:
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  24. Hours Accumulated:
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  25. School Name:
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  26. Attended From:
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  27. Attended To:
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  28. Hours Accumulated:
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  29. School Name:
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  30. Attended From:
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  31. Attended To:
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  32. Hours Accumulated:
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  33. School Name:
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  35. Attended To:
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  36. Hours Accumulated:
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  37. School Name:
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  38. Attended From:
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  39. Attended To:
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  40. Hours Accumulated:
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  41. How did you hear about ENMU-R?:
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  42. If you selected "Other", please explain the source:
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  43. Areas of Interest



















































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  44. Do you or your family members wish to receive publications in Spanish, when available?:
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