Commuter and Off-Campus Programs Intake Form

Commuter and Off-Campus Programs is part of Northern Illinois University's Student Affairs. The information you provide is for our records only. We will not share your information without your permission.

First Name *

Last Name *

Z-ID *

Alternate Email

Phone Number

Local Street Address

Street Address Line 2

City

State

Postal / Zip Code

Country

Year in School

Student Classification *

Gender

Ethnicity/Race

Purpose of Contact/Visit *

Do you need to schedule an off-campus living appointment? *

Yes

No

Do you need permission to be added to Carpool Connections?

How were you referred to us?