Midwest Central High School College and Career Fair

First Name

Middle Name:

Last Name

Preferred First Name

Email Address

Birthdate

Select which one describes you best:

I am in high school.

I have graduated high school but did not attend college after.

I attended college after high school graduation.

I have or will graduate from college with a bachelor's degree and want a second bachelor's degree.

I have or will graduate from college with a bachelor's degree and want to earn a master's degree.

When do you want to start?

Do you plan to enroll in a 100% online degree program?

Yes

No

What do you want to study?

Please list your high school:

Level of study

High School

Please list the college you are currently attending or most recently attended:

Are you interested in the following programs? You can mark more than one:

Graduate Assistantship (GA)

Graduate Public Service Internship (GPSI)

Illinois Legislative Staff Intern Program (ILSIP)

Not Interested

Cell Phone Number

Can we text you about information related to UIS?

Yes

No

Would you like to receive telephone calls that deliver AI messages and SMS that provide details about University of Illinois Springfield?

Yes

No

Would you like to provide us with additional information, such as your address and parent information?

Yes

No