E-mail address:

What is your home telephone number?

What is your work telephone number?

Where did you learn about Upper Iowa University? (Please check or provide information for all that apply.)
Education Officer

Current or Former Student

UIU Publication or Brochure

Independent Study Reference Guide:

College or University. Please provide name:

Center Student. Please provide location of the center:

Internet. Please provide Internet source:

Advertisment. Please provide type of advertisement:

Other. Please describe this other source:

What materials would you like to receive in addition to a copy of the External Degree Bulletin? (Please check all that apply.)
CLEP information
Experiential Learning Brochure
Financial Aid information
Registration Materials
Other. Please describe what other materials you want:

Please enter any comments or questions you have about the External Degree Program.