Undergraduate Request for Information from IU Southeast

We only use your cell phone to identify you and will not be calling or texting you.  

Here is an example of how your birth date should be entered. 08/24/2000

You do NOT have to answer the questions below. 

You may answer as few (including none) 
or as many as you wish.  When you are 
finished click the submit button.

Please keep in mind that if you are interested in receiving anything in the mail, including catalogs, we will need your street address.

Ethnicity (check all that apply)
Available Contact Fields
By  providing your email address, you are opting to receive emails from IU Southeast.
Available Opportunity Fields
Available Campaign Member Fields
Available Campaign Fields
Required Opportunity Fields (can leave hidden but must stay on the form)
Required Campaign Member Fields (keep hidden but need to keep on form)
Required Campaign Fields (may keep hidden but need to keep on form)