Information Request

Legal First Name

Legal Last Name

Legal Middle Name/Initial

Chosen First Name

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Chosen Last Name

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Pronouns

Birth Date

Enter your birthdate in a mm/dd/yyyy format.

Please note that completing and submitting this form provides consent without obligation to McHenry County College and University Center at MCC partners to call, text, and/or email you regarding your educational goal at the number and/or email address listed.

Email Address

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Cell Phone

Street

City

State

ZIP Code

Student Status

How did you hear about the University Center at MCC?

When are you interested in starting?

Which university would you like to attend?

Which major are you interested in?

Looking for a different major that you don't see here? Let us know which one:

Is there anything else we can help you with?

Tell us a little about yourself and we'll be in touch soon!