Fall 2026 Time Out for Tech

Email Address

Legal First Name

Preferred Name

Last Name

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Cell Phone Number

Can we text you regarding this event?

Yes

I am entering as a

I plan to enroll

I am interested in majoring in

I will graduate high school

High School Name

Are you a Louisiana Tech legacy?

Yes

How many guests will you be bringing?

Parent/Guardian Contact Information

Please list any parent/guardian that you would like to receive event confirmation and reminder communication.

Parent/Guardian 1 First Name

Parent/Guardian 1 Last Name

Parent/Guardian 1 Email Address

Would you like to list an additional parent/guardian? Please list any additional parent/guardian that you would like to receive event confirmation, reminder communications.

Yes

Additional Parent/Guardian Contact Information

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Email Address