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Bright Night 2009 Registration Form There is a $15 registration fee per student! Mail the $15 registration fee to: Drury University Office of Admission 900 North Benton Avenue Springfield, Missouri 65802 Fields with * are required. First Name* Last Name* Address* City* State* MO AK AL AZ AR CA CO CT DE FL GA HI IA ID IN IL KS KY LA MA MD ME MI MN MS MT NC ND NE NH NJ NM NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code* Phone* E-mail* High School* Year of Graduation* GPA* Academic Interest* ACT* 23 or below 24-28 29-31 32-34 Gender* Male Female Will you be staying overnight?* Yes No Including yourself, total number attending:* Sunday tour  Monday lunch     Questions and Comments:

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