Prospective Student | Request for Information

Thank you for your interest in Roosevelt University. We are excited to share our story with you and look forward to working with you in the coming days. Please complete the following form in order to receive information regarding the admission process, our academic programs, financial assistance and life at Roosevelt.

Not a prospective student? Submit your questions to Roosevelt by completing the General Request Form.

Personal Information

First Name*

Middle Name

Last Name*

Birthdate*

Contact Information

Email Address*

Preferred Phone Number

Would you like to opt-in to receiving SMS (text) messages from Roosevelt University?

Yes

No

Address

Country

Street

City

Region

Postal Code

Academic Plan

As which of the following student types do you plan to enter Roosevelt?*

Anticipated Entry Term*

Are you applying as an international student? (An international student will be in F-1, J-1, or H-1 visa status.)*

Yes

No

Are you a veteran or an active military member?

Program of Study

Are you interested in a program within the Chicago College of Performing Arts (i.e. music, theatre)?*

Yes

No

Academic Program of Interest*

Academic Emphasis

Academic History

Please select the institution (high school, community college, or college/university) you currently attend or most recently attended.

Unable to find your school?

If you were home-schooled, select Home School
If you completed a high school equivalency exam (GED), select GED
If you cannot find your school, select Unlisted High School or Unlisted College

Search for School*

CEEB Code