Request Information From NEIU

Thank you for your interest in Northeastern Illinois University!

Please share a few details about yourself using the form below.
This will help ensure you receive the appropriate information.

Parent Information

Parent First Name

Parent Last Name

What is your area of interest:

Parent Email Address

Relationship Type

Student Information

First Name

Last Name

Birthdate (used to match prior records)

Contact Information

Email Address

Mobile Number

Would you like to receive text messages from NEIU?

Yes

Mailing Address

Country

Street

City

Region

Postal Code

Academic Information

What level of study are you interested in learning more about?

Intended Undergraduate Major

Graduate Program of Interest

Entry Term

Are you an international student (require a visa to attend university)?

High School Name

Current or Last School Attended

School Level of Study

Add Parent/Guardian Information

I would like to provide parent/guardian contact information.

Parent First Name

Parent Last Name

Parent Email Address

Relationship Type