Request More Info

We're excited you're interested in Illinois! Much of this form is optional, but the more you tell us, the better we can communicate with you. If you have any questions in the meantime, don't hesitate to contact us.

Student Information

First Name

Preferred First Name (if different from First Name – Optional)

Middle Name (Optional)

Last Name

Suffix (Optional)

Birthdate

Sex (Optional)

Female

Male

No Response

Student Email Address

Student Type

Freshman

Transfer

Freshman Entry Term (when you would enroll at Illinois)

Transfer Entry Term (when you would enroll at Illinois)

Current School (Optional)

Current School Code (Optional)

Address

Mailing Address

Country

Street

City

Region

Postal Code

For the purposes of the European Union General Data Protection Regulation,
do you reside in the European Economic Area? (Optional)

Yes

No

Ethnicity/Race (Optional)

Ethnic Identification (Optional)

Hispanic/Latino

Not Hispanic/Latino

Race Identification (Optional)

Phone Number (Optional)

Cell Phone Number (Optional)

May we send you text messages? (Optional)

Yes

No

Alternate Phone Number (Optional)

Academic Interest(s) (Optional)

Tell us the Illinois major(s) you're interested in. If you want descriptions, career data, academic profiles, etc., please explore our majors. (Optional)

Family Contacts (Optional)

Family Contact 1

Contact 1 First Name (Optional)

Contact 1 Last Name (Optional)

Contact 1 Relationship (Optional)

Contact 1 Email Address (Optional)

Contact 1 Phone Number (Optional)