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This site is designed to gather information about prospective students interested in attending the University of Illinois. This web site is secure and the information provided to the University is confidential. It will not be sold to third parties.

Please provide as much information as possible as it helps us maintain accurate records.

- indicates a required field.
Please type in your name using a mixture of upper and lower case letters as you would want it to appear on official documentation. (Example: First Name=John; Middle Name=Allen; Last Name=MacMillan).

Suffix is an optional field.
You may leave the Suffix field blank, but if a suffix is part of your legal name, enter one of the following valid suffixes: I, II, III, IV, V, VI, VII, Jr, Sr.

Prospect Name
Prefix:
First Name:
Middle Name:
Last Name:
Suffix:
Nickname:

Please provide your complete mailing address. This should be the address where you are most reliably reached by mail. For Address Line 1, please enter street address or PO Box using complete words (no abbreviations) and upper and lower case letters (Example: 123 South Monroe Street). For Address Line 2, please enter apartment number and/or additional street address information (Example: Apartment 1A). Use the drop down menus for State, County (Illinois only) and Nation.

Enter your phone number in the following format:
Box 1=area code; Box 2=7-digit phone number; Box 3=extension (if applicable)
Example:
217 5556600 ext

Primary Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Please provide your primary e-mail address and notify us if it changes.

E-Mail Address
E-mail Address:
Verify E-mail Address:

Please indicate your gender below.

Prospect Gender
Gender: Male Female Not Specified

Please indicate your date of birth.

Prospect Birthdate
Date of Birth: Month Day Year (YYYY)

Please indicate your ethnicity and race below.

Ethnic Identification and Racial Identification Note: Your response to these items is voluntary. Please enter the ethnic and racial identification information to help the University meet its federal reporting obligations. Additional information about these regulations is available in the Race and Ethnicity section of the University of Illinois web site.

First, identify whether or not your ethnicity is Hispanic or Latino, regardless of race. Second, select one or more races from the five racial groups. Hold down the Control key in order to select more than one racial group.

Prospect Ethnicity/Race
Ethnicity:

First, identify whether or not your ethnicity is Hispanic or Latino, regardless of race.

Hispanic or Latino
Not Hispanic or Latino

Second, select one or more races from the five racial groups. Select as many as apply.

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
American Indian or Alaska Nati
Asian
Black or African American
Native Hawaiian or Other Pacif
White

Please indicate the semester in which you intend to enter the University.

Prospect Entry Term
Term of Entry:

Please select your intended major or field of study from the pull-down menu.

Prospect Major
Major:

Please indicate the high school from which you will / have graduate(d). If you are not sure of the day of your graduation, use the first day of the appropriate month. (Example: June 01 2004) Click on Look Up High School Code to locate your school. This will automatically fill in the address information. If you do not find your high school in the drop-down list, enter as much information as you can in the fields provided. If you did not graduate from high school but passed your GED exam, please enter code 960000 as your high school code and use your GED date as your graduation date. Enter the GPA on a 4.0 scale.

Prospect High School
Home Schooled (check for yes):
OR
High School Code:
High School Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Graduation Date: Month Day Year (YYYY)
Class Rank and Size: / (must be numeric)
GPA: (example: 9.99, or A+)

Enter the results of any college entrance tests you have taken. These will be considered unofficial scores. Please have your official test scores sent to the Office of Admissions by the testing agency if you plan to apply for admission. You may report up to eight test results.

Prospect Test Scores
Test Type: Test Score: Test Date:
Month Year (YYYY)  
Month Year (YYYY)  
Month Year (YYYY)  
Month Year (YYYY)  
Month Year (YYYY)  
Month Year (YYYY)  
Month Year (YYYY)  
Month Year (YYYY)  

Please indicate one to five areas of interest. To select multiple interests use Ctrl+Click for PC and Command+Click for Mac.

Prospect Interests
Interests:

Please indicate how you learned about this campus of the University of Illinois.

How Prospect Learned About Us
How I Learned About University of Illinois:

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Release: 8.7.2.12