Coastal Bound Intent

Please complete this form to indicate your intent to participate in the Coastal Bound program at Coastal Carolina University.

*Students who were previously enrolled at Coastal Carolina University are not eligible for the Coastal Bound program.

* Have you previously attended Coastal Carolina University?

Yes

No

Contact Information

* First Name

Middle Name

* Last Name

* HGTC Email Address

* Birthdate

* Mailing Address Information

Country

Street

City

Region

Postal Code

Student's Mobile Phone Number

I give permission to Coastal Carolina University to send text messages to my cell phone number. (Message and data rate charges from your carrier may apply.)

Yes

No

Academic Information

* When are you thinking of enrolling?

* Major of Interest

College Information

Most Recently Attended College Name

College CEEB