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Shadow Program Registration Form

Fill this form out so we can match you with the best possible EIU student!

Fall 2011 dates are full.

Spring 2012 dates include:
-Monday, January 23 to Wednesday March 7
-Tuesday March 20 to Thursday April 19

Name * First Last
Hometown *
State
Email *
Phone * - (###) - ### ####
High School You're Currently Attending:
What year are you in school? * Freshman Sophmore Junior Senior
You must be a Junior or Senior to register EIU's Shadow Program.
When Do You Plan to Start College? *

(Ex. Spring 2011, Fall 2009)
How did you hear about the Shadow Program?
What major or career path are you considering? *
Why are you considering Eastern Illinois University? *
What activities were/are you involved in during high school? *
What dates would you be interested in shadowing a student? Please list them in order of preference:
Shadow visits days are available on Mondays, Tuesdays, Wednesdays and Thursdays
January 23 to March 7
March 20 to April 19 * / MM / DD YYYY
* / MM / DD YYYY
* / MM / DD YYYY

Eastern Illinois University Homepage

I am an incoming...

E-number and Net ID Information

Orientation, Advisement & Registration Parking Information

Volunteer Opportunities

Business & EIU Community Opportunities

Overview

Shadow Program Registration Form

Shadow Program Registration Form