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1701 North State Street  Jackson, MS 39210-0001  (800)352-1050  (601)974-1000
Millsaps College

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Millsaps College Student Referral Form

The aim of this program is to increase applications from well-qualified students.  Even if the student has already been admitted, we ask that you still complete this form.  The strength of your referral may carry additional weight when applicants are considered for admission and scholarships to Millsaps College, however no pre-determined scholarship amount will be automatically awarded.
Your Information:
* = Required Fields. Please submit a separate form for each referral you would like to submit.

*How do you know the student (please select one)?
Prospective Student Information:
Student's Gender
Student's Birthdate

Student Type
Parent Information:
* = Required Fields.  Please submit a separate form for each referral you would like to submit.
Thank you for taking the time to complete this form. Upon successful submission of this form, you will receive a confirmation message.