Western Illinois University

* Current Status

I am currently in a graduate program at Western Illinois University and would like to change my program of study.

I am currently in a graduate program at Western Illinois University and would like to apply to an additional graduate program.

I am currently a non-degree graduate student and would like to apply to a graduate program.

* Graduate Program Options

Graduate Degree

Second Bachelor's degree

Post-baccalaureate certificate

Non-degree

* Form Information

If currently in a graduate program and applying to another program, do you intend to complete your current program before beginning a new program?

Yes, if accepted I will begin the new program upon completion of my current program.

No, if accepted I will pursue the new program only.

No, if accepted I will pursue both the current and new program simultaneously.

Not Applicable

Returning For:

Semester:

Year:

Location:

Macomb - Residential Campus

Quad Cities - Non-Residential Campus

Online - Fully Online

Personal Information

* Last Name:

* First Name:

* WIU ID #:

* Street Address:

Apartment/Suite:

* City:

* State:

* Postal (Zip) Code:

* Email Address:

Important information will be sent to this address. Ensure that it is valid.

* At least one phone number is required.

Home Phone:

Cell Phone:

* Student Certification

Verify the following:

By checking this box I certify that I am personally seeking admission to Western Illinois University and all information supplied on this form and all credentials submitted are complete and accurate to the best of my knowledge and belief. I understand that withholding information requested on this form or giving false information on this or any WIU document may make me ineligible for reentry to the University or subject to dismissal.

Please take time to review your information before completing your form.
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Western Illinois University

Graduate Studies

Request for Change of Status Form

If currently in a graduate program and applying to another program, do you intend to complete your current program before beginning a new program?

Returning For:

Location:

Verify the following: