Request For Information (Internal Use)

StudentType

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If you are interested in Graduate Programs you need to click here Graduate RFI

Undergraduate

*First Name

Preferred First Name

Middle Name

*Last Name

Birthdate

Phone Number

If the Phone Number supplied is a Cell Phone may we text you?

Yes

No

Email Address

My mailing address is ... ?

Country

Street

City

Region

Postal Code

What school do you currently attend?

Are you going to be a ... ?

Campus?

Major?

When are you planning to start?

Are you or were you associated with the military?, if so please choose from the list below.

Will you be using military benefits? Choose from the list.

EAP

GI Bill

MFEP

TA

Interested in ROTC?

How did you hear about us?

Please describe:

Partner Agency

ReUP ID

Event Type

Event

Event Detail

*Input By:

ReUp Notes