Prospective Student Parent | Request for Information

We are excited to share our story with you and your student and look forward to working with you all. Please complete the following form in order to receive information regarding the admission process, our academic programs, financial assistance and upcoming events.

Your (Parent) Information

First Name*

Last Name*

Email Address*

Relation to Student

Address

Country

Street

City

Region

Postal Code

Student Information

First Name*

Last Name*

Email Address*

Birthdate*

Preferred Phone Number

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

Yes

No

Student Academic Plan

Which of the following student types best describe your student?*

Expected Entry Term*

Is your student international? (An international student will be in F-1, J-1, or H-1 visa status.)*

Yes

No

If your student interested in a program within the Chicago College of Performing Arts (i.e. music, theatre, interdisciplinary)?*

Yes

No

Expected Academic Program*

Academic Emphasis

Student Academic History

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

Unable to find your school?

Home-schooled? Select Home School
Completed a high school equivalency exam (GED)? Select GED
Cannot find the school? Select Unlisted High School or Unlisted College

Search for School*

CEEB Code