Western Illinois University
VISITING STUDENT CONFIRMATION
PLEASE PRINT
Name_________________________________________
Date of Birth____________________
Address______________________________________________________________________________
_____________________________________________________________________________________
City
State
Zip
I plan to be a non-degree (visiting) student at Western Illinois University for the term:
Check one
Fall
Spring
Summer
Year___________
I am currently a student in good academic standing at the following institution:
School_______________________________________________________________________________
Address______________________________________________________________________________
_____________________________________________________________________________________
City
State
Zip
(Current standing subject to review by Office of the Registrar.)
I understand that my enrollment will be for one term only and that I may not be eligible for financial aid.
I understand that I may check my eligibility by contacting the Financial Aid office at 309-298-2446.
I understand that if I desire to continue my education at Western Illinois University as a degree-seeking
student, I will be subject to the normal admissions standards and will be required to submit the
appropriate application materials.
____________________________________________
Student’s Signature
_________________________
Date
Return this form to:
Undergraduate Admissions Processing
Western Illinois University
1 University Circle
Macomb, IL 61455
01-25-11