Dual Credit Visit Request

If you see this don't fill out this input box.

First Name*

Last Name*

Birthdate*

Email Address*

Cell Phone Number*

What high school do you attend?* Please Select Home-Schooled Bureau Valley High School Depue High School Earlville High School Fieldcrest High School Hall Township High School Henry-Senachwine Consolidated High School LaMoille High School LaSalle-Peru Township High School Marquette Academy Mendota Township High School Midland High School Ottawa Township High School Princeton Township High School Putnam County High School St. Bede Academy Seneca Township High School Serena High School Streator Township High School Woodland High School Other

What is your anticipated year of high school graduation?*
If you will be graduating early in December, please put the year you would have graduated with your class.

In what format would you prefer your virtual appointment?*

ZOOM

Phone

Please indicate which times you are available for an appointment* Wednesdays 1:00pm - 3:00pm Wednesdays 5:00pm - 7:00pm Fridays 1:00pm - 3:00pm
You can click on more than one time frame that works for you. You will be contacted with an appointment time.

What is your intended program of study?*
It is okay if you are undecided, you can list undecided or add a couple of programs that interest you.

Do you have particular topics or questions you would like to discuss at your visit? You may also add any additional information in the space provided below.

Form UUID Site Name Submit Your Visit Request  Clear