Name*

Email Address *

Class
Freshman
Sophomore
Junior
Senior

Are you currently an eiu4 student?
Yes
No

Is this your first appointment with the eiu4 Coordinator?
Yes
No

Appointment times are between 9:00am and 4:00pm, Monday through Friday

Preferred day?*
Monday
Tuesday
Wednesday
Thursday
Friday

Preferred time?*
Morning
Afternoon

Reason for Appointment or Comments/Special Instructions

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Just click Submit and I will e-mail you back a time and date for the meeting.