Nursing Visit Day

Who is completing this registration?

Prospective Student

Parent or Family Member

Supporter

First Name*

Last Name*

Preferred Name

Email Address*

Student Cell Phone*

I give permission to Illinois College to send me important updates
via text messaging. (Standard message charges apply.)

Yes

Address*

Country

Street

City

Region

Postal Code

I will enter college as a*

Start Term*

High School Name*

College Name
(required only if a transfer student)

Primary Area of Academic Interest

Secondary Area of Academic Interest

Have you been in contact with an IC coach regarding participating in a NCAA DIII Sport?
PLEASE NOTE: If your visit is reliant on meeting with a coach, please coordinate your visit with that coach.

Yes

No

Visit Coach

Yes

No

Will you be bringing any guests with you?

Guest Information

Guest Relation*

Guest First Name*

Guest Last Name*

Guest Email Address
A copy of your registration confirmation will be sent to this email address if provided.

Guest #2 Information

Guest #2 Relation*

Guest #2 First Name*

Guest #2 Last Name

Guest #2 Email

Guest #3 Information

Guest #3 Relation*

Guest #3 First Name*

Guest #3 Last Name*

Guest #3 Email

Additional Information

The campus tour is a walking tour led by an IC Ambassador. Do you require any accommodations or have accessibility concerns?

Yes

No

Please let us know what accommodation would be best.

Please let us know if you have any dietary restrictions so we can plan accordingly.

Do you have any other requests for your campus visit?

How did you hear about us?

What is your t-shirt size?