WSU Guest Information Form

Fields with asterisks (*) are required.

Program Name *

Preferred First Name/Nickname *

Last Name *

Full Legal Name (as on passport) *

Faculty Member Sponsor *

Relationship *

Current Address & Contact Information

Address line 1 *

Address line 2

City *

State/province/region *

Postal/zip code *

Country *

E-mail Address *

Most correspondence from our office will be via e-mail.
Please list one you check regularly.

Phone Number *

Alternative Phone Number *

Country of Citizenship *

**Please note: If you are not a US Citizen, it is your responsibility to obtain a visa to enter the country you will be visiting. Not all programs require a visa so check online or with an advisor if you are uncertain.

Date of Birth *

Gender *

Male

Female

Emergency Contact

Please list who should be notified in case of emergency

Name *

Relationship to you *

Address *

City *

State *

Zip Code *

Cell Phone Number *

Home Phone Number

Work Phone Number

Fax (optional)

E-mail Address *