Event Registration Home * Required Palmerpalooza: A Campus Visit Experience Saturday, July 20 Palmer College of Chiropractic - San Jose, California Personal Information * First Name Middle Name * Last Name * Email * Phone Mobile Home Work Mailing Address * Street Address * City * State/Province * Postal code Home StateHome State ReferralHow did you hear about us? Select one Website - Palmer Website - Other Chiropractor - Palmer grad Chiropractor - non-Palmer grad Admissions Representative Email Mail invite Name of ReferrerEmailPhoneAddress GuestsNameAlumniNameAlumniNameAlumni Current SchoolSchool NameSchool CitySchool State Clinic AppointmentSchedule an appointment? Select one Yes No Hotel Accommodations** Palmer will accommodate a one or two-night stay for those residing outside a 80-mile radius of the campus.By requesting a hotel, I acknowledge that I am at least 18 years of age or older. * Please choose one of the following: Select one Two-night stay accommodations One-night stay accommodations I do not need any hotel accommodations Casino Night AttendanceWill you be attending our Casino Night reception on Friday, July 19th? * Select one Yes No Any questions, concerns, needs or special accommodations?