Center for Autism and Neurodiversity (CAN) Information Session

Student Information

First (Given) Name

Do you prefer we use a different first name for official communications to you?

Yes

Preferred First Name (optional)
Your preferred name will be used in email and text communications we send to you.

Last (Family) Name

Previous Last Name (optional)

Date of Birth

Mailing Address

Country

Street

City

Region

Postal Code

Email and Phone

Email Address

Parent's Email Address

Mobile Phone (optional)

Would you like to receive information via text message? Standard text messaging rates may apply. (optional)

Yes

No

Your Intended Plan of Study at Drexel

Student Type

Planned Entrance Term

Academic Area of Interest

Major

Intended graduate program interest (primary interest)

Other

If applicable, secondary graduate program interest