Greenville Transfer Request Form

Desired Program of Study at Illinois College*

Desired Enroll Term at Illinois College*

Desired Start Month at Illinois College*

Home/Permanent Address*

Country

Street

City

Region

Postal Code

Additional Contact Information

Email Address*

Mobile Phone

Text opt in*

Yes

No

Personal Information (this optional information is used to prepare a financial aid offer):

Social Security Number
(only numbers, no dashes)

Birthdate*

I certify that all information submitted in the admission process – including the Transfer Request Form, any supplements and any other supporting materials – is my own work, factually true and honestly presented. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I’ve certified be false. I further understand that it is my responsibility to update or supplement my responses if any information should change and that failure to do so may result in the actions described above. In addition, I authorize the release of my admission decision to my secondary school.

In place of your signature, please type your full legal name:*

App Round

Instruction Location

Generate PIN

App Submitted Flag

App Priority

GU TO Transfer

Staff Assignment

Staff Assignment Locked