Prospect Data Entry Form

Please enter your information in the following forms.

- indicates a required field.

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 hwskwpro.P_WebProspectMain procedure.

Prospect Entry Term
Term of Entry:

This is sample information text for the INTERESTS 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 hwskwpro.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.

Prospect Interests
Interests:

This is sample information text for the MAJOR 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 hwskwpro.P_WebProspectMain procedure.

Prospect Major
Major:

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 hwskwpro.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 hwskwpro.P_WebProspectMain procedure.

Primary Address
Valid From:	Month Day Year (YYYY)
Until:	Month Day Year (YYYY)
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number:	- (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

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 hwskwpro.P_WebProspectMain procedure.

E-Mail Address
E-mail Address:
Verify E-mail Address:

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 hwskwpro.P_WebProspectMain procedure.

Prospect Birthdate
Date of Birth:	Month Day Year (YYYY)

This is sample information text for the SSNTINTFN 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 hwskwpro.P_WebProspectMain procedure.

Prospect SSN/TIN/TFN
U.S. Social Security Number:	(999999999 or 999-99-9999)

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 hwskwpro.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 North Shore Community College:

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North Shore Community College

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