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Project 90 Inquiry Form

REQUEST MORE INFORMATION ABOUT PROJECT 90 FROM SIU

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Student Information

First Name

Last Name

Preferred Email Address

Birthdate

Birthdate

May we send you text messages?

Cell Phone

Phone

Would you like to provide your mailing address?

Mailing Address

Country

Street

City

Region

Postal Code

Enrollment Information

When do you plan to begin attending SIU?

I am interested in SIU as a:

Location you are interested in taking courses:

Primary Academic Interest