UNIVERSITY OF ILLINOIS CENTER FOR WOUNDED VETERANS IN HIGHER EDUCATION (CWVHE) CENTER REGISTRATION APPLICATION

UNIVERSITY OF ILLINOIS CENTER FOR WOUNDED VETERANS IN HIGHER EDUCATION (CWVHE) CENTER REGISTRATION APPLICATION

Dear Prospective Student:

Thank you for your interest in services for military-connected students (veterans, guard/reservists, and dependents) offered by the CWVHE. It is important that you complete this application and an orientation session to utilize Center services. Once you complete this application, you will be contacted by a CWVHE staff member to schedule your orientation session. Please note that services cannot begin until a completed registration (application and orientation session) is on file in the Center’s Clinical Services Office.

If you are seeking academic accommodations, you will need to supply supporting disability documentation as a part of the registration process. Such information will help us work with you to plan effective academic adjustments, auxiliary aids, or services during your tenure as a student at Illinois. Documentation requirements will be given to you at your orientation session, and we are happy to work with you to obtain these records.

I. BACKGROUND INFORMATION

 

 

 

required4. Gender

required4. Gender

 

 

 

 

required9. Subject to Recall

required9. Subject to Recall

10. Race/Ethnicity (optional for statistical purposes) Select one or more:

10. Race/Ethnicity (optional for statistical purposes) Select one or more:

 

 

 

 

answer must be phone number with area code like 217-333-1000

 

answer must be an email address

 

 

 

 

 

answer must be phone number with area code like 217-333-1000

 

Emergency Contact

 

answer must be phone number with area code like 217-333-1000