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REQUEST INFO

(Step 1 of 6)

Personal Info:

*First Name: *Last Name:

Preferred Name: *Date of Birth:

Gender: MaleFemale *Email:

Church:

Denomination:

Country of Citizenship:

*Address:

Country:

*Zip: County:

*City: *State:

*Primary Phone:		*Phone Type:
Secondary Phone:		Phone Type:

*High School State: High School not listed

*High School:

Graduation Year:

*When will you begin attending IWU? of

*Classification: First Time StudentTransfer Student

Intended Major #1:

Intended Major #2:

Indicate past involvements in High School ("HS"), those anticipated for college ("C"), or check both. Please mark the appropriate response.

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