International Request for Information

If you are a prospective international student who would like more information about Western or have a question, please complete and submit this International Request for Information form.

If you are a U.S. citizen or permanent resident, please contact either the domestic Undergraduate Admissions Office at Admissions@wiu.edu or the School of Graduate Studies at Grad-Office@wiu.edu.

(Do not use this form to inquire about the status of your application. Please email the International Admissions staff at International-Ed@wiu.edu.)

Personal Information First Name:

(Given/Personal Name)

Middle Name:
Last Name:

(Family/Surname)

Date of Birth: / /
Gender:
Country of Citizenship: Email Address:

Important information will be sent to this address. Ensure that it is valid.

Email (re-enter):

Please re-enter your e-mail address to confirm.

Enrollment Information I plan to enroll:

I plan to attend:
Western's English-as-a-Second Language (WESL) Program only
Undergraduate Degree Program (select major):

^*Major also available at WIU-Quad Cities campus

(upper division only - must have 60 hours in transfer work)

Graduate Degree Program (select major):

^*Major also available at WIU-Quad Cities campus

^**Major ONLY available at WIU-Quad Cities campus

Request Information

I would like to receive:

Application
More Information

I prefer:

An Email Response
An Informational Packet Be Mailed To Me:

Address:

City:
State/Region:
Country:
Zip/Postal Code:

Comments:

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