Request More Info

We're excited you're interested in UIUC! 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

First-Year

Transfer

First-Year Entry Term (when you would enroll at UIUC)

Transfer Entry Term (when you would enroll at UIUC)

Current School (Optional)

Current School Code (Optional)

Address

Mailing Address

Country

Street

City

Region

Postal Code

For the purposes of the European Union and UK General Data Protection Regulations and China's Personal Information Protection Law, do you reside in the European Economic Area, the United Kingdom, or the People’s Republic of China? (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)