Information Request

Please complete this form to receive more information about Rider University's continuing education programs.

Required fields are marked with an asterisk (*).

Student Type (Hidden Field)

Continuing Education / Adult Learner

Anticipated Start Term *

Program of Interest *

First Name *

Preferred/Lived Name

Last Name *

Have you attended Rider previously under a different last name?

Yes

No

Previous Last Name while attending Rider

Birthdate *

Email Address *

Mailing Address

Country

Street

City

Region

Postal Code

Cell Phone Number

Would you like to receive information by text message?

Yes

No

If your company or organization has a Partnership Agreement with Rider, please select from the list below.

NJ Bankers Association Member

Princeton Mercer Regional Chamber Member