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Information Please enter the requested information. Please note that an asterisk denotes required information.

Required - indicates a required field.
Information This is sample Information text for the NAME section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

Prospect Name
Prefix:
First Name: Required
Middle Name:
Last Name: Required
Suffix:
Nickname:

Information This is sample
Information text for the ADDRESS1 section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

Primary Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Information This is sample Information text for the BIRTHDATE section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

Prospect Birthdate
Date of Birth:Required Month Day Year (YYYY)

Information This is sample Information text for the SSNTINTFN section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

Prospect SSN/TIN/TFN
U.S. Social Security Number: (999999999 or 999-99-9999)

Information This is sample Information text for the CITIZENSHP section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

Prospect Citizenship
Citizenship:Required

Information This is sample Information text for the GENDER section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

Prospect Gender
Gender:Required Male Female Not Specified

Information This is sample Information text for the EMAIL section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

E-Mail Address
E-mail Address:Required
Verify E-mail Address:Required

Information This is sample Information text for the HOWILEARND section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure. Select the Materials you would like to receive. To select multiple materials use Ctrl+Click for PC and Command+Click for Mac.

How Prospect Learned About Us
How I Learned About BannerWeb:BannerWeb

Information This is sample Information text for the MAJOR section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

Prospect Major
Major:Required

Information This is sample Information text for the ENTRYTERM section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

Prospect Entry Term
Term of Entry:Required

Information This is sample Information text for the ETHNICITY section. Modify or delete this text by choosing the Customize a Set of Information Text option on the Web Tailor Administration menu and selecting the bwskwpro.P_WebProspectMain procedure.

Prospect Ethnicity/Race
Ethnicity:

Note What is your ethnicity?

Hispanic or Latino
Not Hispanic or Latino

Note Select one or more races to indicate what you consider yourself to be.

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White

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Release: 8.7.2.12