First Name*
|
Last Name*
|
Address*
|
Apt/Suite
|
City*
|
State/Province*
|
ZIP/Postal Code*
|
Email Address*
|
Day Phone*
|
Evening Phone
|
When do you expect to start
the program?*
|
Degree of Interest*
|
Program of Interest*
|
| Birth
date:
/
|
Current Level of Education*
|
Year you graduated
|
|
If you have not graduated High School by the end of 2004, we will not contact you.
However, you can download our course catalogue here.
|
Please
describe your reasons for seeking a degree:
|
I am a US citizen
I am a Canadian citizen
I am NOT a US/Canadian citizen |
|
I understand a representative will call me
to discuss the exciting programs and opportunities that fit my lifestyle
and schedule*
|
| *Required field |
|
By submitting this form, a DeVry admissions advisor will be contacting you. They
will provide information on degree programs, financial assistance alternatives,
and answer questions.
... ... ... ... ... ... ... ... ...
... ... ...
|
