Alumni Referral Form

Thank you for referring a student to Houghton University! If you have multiple students to refer, please fill out this form once for each student. Upon submitting this form, you will get a confirmation screen that will allow you to submit another form.

*Required Field

Your Information

Your First Name*

Your Last Name*

Your Email Address*

Student Information

Please fill out whatever information you know about the student. You can leave anything you're unsure of blank. Please provide at least one of the following so that we can make contact with the student: Email, phone, mailing address.

Hidden: Campus Type

Student First Name*

Student Last Name*

Gender*

Student Email Address

Student Phone Number

Student Mailing Address

Country

Street

City

Region

Postal Code

Student College Entry Term

Is the student currently in high school or attending a college full-time?

Anything else you'd like to share about the student?

Alumni Referral Form

Houghton University
1 Willard Avenue
Houghton, NY 14744

+1-800-777-2556
+1-585-567-9200
admission@houghton.edu

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