Self-Service

HELP | EXIT

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 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 ADDRESS2 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.

Secondary 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 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.

BIRTHDATE
Date of Birth:	Month Day 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:

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:

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:

What is your ethnicity?

HispanicNot Hispanic

Hispanic or Latino
Not Hispanic or Latino

Hispanic or Latino

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
*American Indian or Alaskan Native Alaskan Native American Indian Cherokee Chippewa Choctaw Navajo Other American Indian Sioux Vietnamese	*Asian or Asian-American Asian Asian American Cambodian Chinese Filipino Hmong Indian (subcontinent) Japanese Korean Malaysian Other Asian Pakistani Thai	*Black/African American African African American Black Carribean Other Black/African American	*Native Hawaiian or Pacific Islander Guamanian Native Hawaiian Other Pacific Islander Pacific Islander Samoan	Hispanic, Latino/a, Spain White, Non-Hispanic Central American Chicano/a Cuban European Hispanic or Latino/a Mexican, Mexican-American Middle Eastern North African Other Hispanic or Latino/a Other White, Non-Hispanic Puerto Rican South American Spanish (Spain) White-Caucasian

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 HIGHSCHOOL 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 High School
Home Schooled (check for yes):
OR
High School Code:
High School Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Graduation Date:	Month Day Year (YYYY)
Class Rank and Size:	/ (must be numeric)
GPA:	(example: 9.99, or A+)

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 Self-Service:

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 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.

Error occurred while processing main web prospect. ERROR: numeric or value error: character to number conversion error