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Confirmation of Enrollment Form

If filling this form out on a mobile device, we recommend doing so in landscape view for the best user experience
* Denotes required field

First Name*

Middle Name*

Last Name*

Gender*

Female

Male

Birthdate*

Biographical Information

I am a:*

First Year Student

Transfer Student

Returning Houghton Student

How many years of college have you completed?

Contact Information

Mailing Address:*

Country

Street

City

Region

Postal Code

Cell Phone

Email Address*

Emergency Contact Information

Please enter contact information for 2 emergency contacts. When applicable, emergency contacts should include a parent(s) or legal guardian(s).

Emergency Contact 1

First Name*

Last Name*

Phone Number*

Email Address*

Relation to you*

Emergency Contact 2

First Name*

Last Name*

Phone Number*

Email Address*

Relation to you*

Residential Information

I will be a...*

Resident (living in a residence hall)

Commuter (not living in a residence hall but attending classes in person)

Full Time Student

Full Time

Part Time

Enrollment Deposit Payment

The deposit is refundable until May 1 and goes directly toward the cost of attendance.

Payment Preference

Pay online from a checking/savings account or credit card

Pay online through Flywire (for Canadian and International students)

Mail a check to Houghton College

I have already submitted my deposit

Congratulations! We can't wait to see you here this fall!

To pay your Enrollment Deposit online, please submit this form and follow the link available on the confirmation screen.

After submitting this form, you will be prompted to pay online through Flywire.

Mail check to:
Admission Office
Houghton College
PO Box 128
Houghton, NY 14744

In the "Memo" area, indicate the name of the student and enrollment deposit (example: Enrollment Deposit for John Smith).

1 Willard Ave. Houghton, NY 14744
www.houghton.edu | 800-777-2556