Internal Inquiry Form

Internal Inquiry Form

Student's First Name

Student's Last Name

Student's Birthdate

Country

Street

City

Region

Postal Code

Student Cell Phone

Student's Email Address

Did the student opt in to SMS (text messages)?

Student's current or most recent high school/college:

CEEB Code

Prospective Student Level

Prospective Student Type

Student plans to attend SIU beginning in:

Location student is interested in taking courses:

Site

Student's Primary Academic Interest

Student's Secondary Academic Interest

Graduate Academic Interest