Program Inquiry

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Personal Information

Name: First *
 Last: *
Preferred Name:
  
Month/Day of Birth: *
(For uniqueness)
  
Street / PO Box: *
  
City: *
 State / Province: *
Zip/Postal: *
  
Country:
  
E-mail: *
  
Home Phone: *
 Cell:
Work Phone:
  
Fax:
  
Occupation:
  
Include a Financial Aid Packet?
 U.S. Veteran?
Previous College or University?
 U.S. Citizen?
Which of the following have you earned?

Some Credits | Associates | Bachelors | Masters | Doctorate

Other (please specify):

I am interested in:

Indicate your interest by checking the boxes below. Use the "Comments" box at the bottom of this form to tell us your general academic interests, specific needs, or program of interest (remember you can choose your own academic areas). This helps us provide you with personalized information.

 

Undergraduate Programs

UI&U Undergraduate programs offer the B.A. or B.S. degree for learners within commuting distance of UI&U centers as well as distance learning accommodations, and specialize in individualized degrees.

Please indicate your preference(s) in mode of study:
Brief Residencies At a distance Convenient classes no preference

Please indicate your area(s) of interest: (please select at least one)
Psychology/ Counseling Criminal Justice Education/Teacher Certification Business Management/Administration
Social Work Holistic Studies Public Administration Lactation Consulting
Writing/Literature Visual Art Health Care Management Historical/Cultural Studies
Environmental/Science Studies Sociology Organizational Management Women's/Gender Studies
Human Resource Management Other (please Indicate): Undecided

Masters Programs
(accomodates distance learning)

Master of Arts Master of Education - Florida Center
Master of Education -  Montpelier Center Master of Fine Arts in Writing
Master of Fine Arts in Visual Art Department of Psychology & Counseling
Master of Fine Arts in Writing for Children and Young Adults  
Areas of Interest (if known):

Doctoral Programs

PhD Interdisciplinary Arts & Sciences Psy.D. in Clinical Psychology
Ed.D. with specialization in Educational Leadership (K-12) or Higher Education Leadership
Areas of Interest (if known):
Other
Online Seminars & Workshops Conferences

 

Help us by letting us know how you found out about us - check all applicable boxes:

Word of Mouth (professor, friend, co-worker, family member, etc.)
Advertisement - where?
Internet - which site?
Direct Mail
Other - please describe:

 

Comments/Questions
If you have specific questions or comments please let us know.  An information packet will be mailed to the above address and we will contact you.