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Please enter the requested information. Please note that an asterisk denotes required information.
- indicates a required field.
This is sample Information text for the NAME section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.
Prospect Name
Prefix:
First Name:
Middle Name:
Last Name:
Suffix:
Nickname:
This is sample
Information text for the ADDRESS1 section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.
Primary Address
Valid From:
Month
None
January
February
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April
May
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September
October
November
December
Day
None
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31
Year
(YYYY)
Until:
Month
None
January
February
March
April
May
June
July
August
September
October
November
December
Day
None
01
02
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Year
(YYYY)
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
None
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
Australian Capitol Territory
British Columbia
California
Canal Zone
Colorado
Connecticut
Delaware
District of Columbia
Florida
Foreign State
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Mariana Islands
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Military - Americas
Military - Europe
Military - Pacific
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Foundland
New Hampshire
New Jersey
New Mexico
New South Wales
New York
Newfoundland
North Carolina
North Dakota
Northern Mariana Islands
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
Prince Edward Island
Provence of Quebec
Puerto Rico
Quebec
Queensland
Rhode Island
Saskatchewan
South Australia
South Carolina
South Dakota
Tasmania
Tennessee
Texas
Utah
Vermont
Victoria
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIP or Postal Code:
County:
None
Nation:
None
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burma
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
China (Taiwan)
Columbia
Comoros
Congo
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
DO NOT USE
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guam
Guatemala
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Mauritania
Mauritius
Mexico
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
Norway
Oman
Pakistan
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Lucia
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Scotland
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Korea
South Yemen
Spain
Sri Lanka
St. Kitts and Nevis
St. Vincent and Grenadines
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
The Bahamas
Togo
Tonga
Tongo
Trinidad and Tobago
Tunisia
Turkey
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Unknown
Unknown
Upper Volta
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Wales
Western Samoa
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
Phone Number:
-
(xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:
This is sample Information text for the BIRTHDATE section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.
Prospect Birthdate
Date of Birth:
Month
None
January
February
March
April
May
June
July
August
September
October
November
December
Day
None
01
02
03
04
05
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Year
(YYYY)
This is sample Information text for the CITIZENSHP section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.
Prospect Citizenship
Citizenship:
None
Citizen
Legal Permanent Resident
Non-Citizen
This is sample Information text for the ETHNICITY section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.
Prospect Ethnicity/Race
Ethnicity:
None
American Indian or Alaskan Nat
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Asian Pacif
Two or more races
White
What is your ethnicity?
Hispanic
Hispanic or Latino
Not Hispanic
Not Hispanic or Latino
Select one or more races to indicate what you consider yourself to be.
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Prefer Not to Answer
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Prefer Not to Answer
This is sample Information text for the GENDER section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.
Prospect Gender
Gender:
Male
Female
Not Specified
This is sample Information text for the EMAIL section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.
E-Mail Address
E-mail Address:
Verify E-mail Address:
This is sample Information text for the ENTRYTERM section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.
Prospect Entry Term
Term of Entry:
None
Fall 2010
Fall 2011
Spring 2011
Spring 2012
Summer 2010
Summer 2011
This is sample Information text for the PRIORCOLL section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.
Prospect Prior College
College Code:
Prior College Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
None
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
Australian Capitol Territory
British Columbia
California
Canal Zone
Colorado
Connecticut
Delaware
District of Columbia
Florida
Foreign State
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Mariana Islands
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Military - Americas
Military - Europe
Military - Pacific
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Foundland
New Hampshire
New Jersey
New Mexico
New South Wales
New York
Newfoundland
North Carolina
North Dakota
Northern Mariana Islands
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
Prince Edward Island
Provence of Quebec
Puerto Rico
Quebec
Queensland
Rhode Island
Saskatchewan
South Australia
South Carolina
South Dakota
Tasmania
Tennessee
Texas
Utah
Vermont
Victoria
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
ZIP or Postal Code:
Nation:
None
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burma
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
China (Taiwan)
Columbia
Comoros
Congo
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
DO NOT USE
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guam
Guatemala
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Mauritania
Mauritius
Mexico
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
Norway
Oman
Pakistan
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Lucia
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Scotland
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Korea
South Yemen
Spain
Sri Lanka
St. Kitts and Nevis
St. Vincent and Grenadines
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
The Bahamas
Togo
Tonga
Tongo
Trinidad and Tobago
Tunisia
Turkey
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Unknown
Unknown
Upper Volta
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Wales
Western Samoa
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
Attended From:
Attended To:
Graduation Date:
Month
None
January
February
March
April
May
June
July
August
September
October
November
December
Day
None
01
02
03
04
05
06
07
08
09
10
11
12
13
14
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16
17
18
19
20
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29
30
31
Year
(YYYY)
GPA:
(example: 9.99)
Degree:
None
Associate of Science in Nursin
Associate's Degree
Bachelor of Arts
Bachelor of Science
Bachelor of Science in Nursing
Bachelor's Degree
DNP/PhD
Diploma
Doctor of Education
Doctor of Philosophy
Doctoral Degree
Doctorate of Nursing Practice
High School Diploma
Juris Doctorate
Master of Arts
Master of Education
Master of Fine Arts
Master of Library Science
Master of Public Health
Master of Science in Nursing
Master's Degree
Post Master's Certificate
Unclassified
Undeclared
This is sample Information text for the HOWILEARND section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure. Select the Materials you would like to receive. To select multiple materials use Ctrl+Click for PC and Command+Click for Mac.
How Prospect Learned About Us
How I Learned About GSON Information System:GSON Information System
None
Admissions Representative
Alumni
Barnes-Jewish Employee
Campus Visit
College Counselor
College Fair
High School Counselor
Print Ad
Relative/Friend
Television Feature
Web Site
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