College of Engineering Event/Visit Reservation Form
First Name:
Middle Name:
Last Name:
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Nickname: prefer to be called
Gender: Male Female
Date of birth: (use format: mm/dd/yyyy)
I am most comfortable describing myself as: African American Asian Caucasian Latino Native American Other (optional)
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Term for which you plan to apply or have been admitted: Spring 2009 Fall 2009 Spring 2010 Fall 2010 (Freshmen can only apply in Fall terms)
Applicant type: Freshman Transfer Readmit
Are you a U.S. citizen or permanent resident? U.S. Citizen Permanent Resident Other
Academic interest #1: Bioengineering Chemical Engineerin Civil ENgineering Computer Engineering Computer Science Electrical Engineering Engineering Management Engineering Physics Industrial Engineering Mechanical Engineering
Academic interest #2: Bioengineering Chemical Engineerin Civil ENgineering Computer Engineering Computer Science Electrical Engineering Engineering Management Engineering Physics Industrial Engineering Mechanical Engineering
Academic Interest #3: Bioengineering Chemical Engineerin Civil ENgineering Computer Engineering Computer Science Electrical Engineering Engineering Management Engineering Physics Industrial Engineering Mechanical Engineering
Total additional guests:
What would you like to attend?
information session
tour
departmental visit
other (please describe)
specialized event (see below)
Prospective Engineering Student Day at a UIC Basketball Game Saturday, February 21, 2009 UIC Men's Basketball vs Southern Illinois UIC Pavilion - 7:00 PM (space is limited only 2 tickets per student)