:: Ohio University Eastern - Campus Information Request Form ::

First Name:

Last Name:

Address 1:

Address 2:

City:

State:

Zip Code:

E-mail Address:

Confirm E-mail:

Telephone Number:

Gender:

Male
Female

Date of Birth (Month/Day/Year):

Student Status:

Freshman
Transfer

Highest Education Level Earned:

High School -- Year of Graduation:

GED
Some college
Associate's Degree
Bachelor's Degree
Master's Degree

Colleges attended:

Information Requested:

Application
Viewbook
Schedule of Classes
Financial Aid Info.
Master's Degree Info.
Independent Study Brochure

Intended Major

If "Other Major," please enter your major here

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