1555 South Raisinville Road Monroe, Michigan 48161
1555 South Raisinville Road Monroe, Michigan 48161
INQUIRY TRACKING
INQUIRY TRACKING
Student Information Information Student
Student Information Information Student
Last Name: _______________________ First name: _________________ MI:_____
Last Name: _______________________ First name: _________________ MI:_____
Address: __________________________ Address 2: _________________________
Address: __________________________ Address 2: _________________________
City: ___________________________ State: _________________ Zip: __________
City: ___________________________ State: _________________ Zip: __________
Cell Phone: (_______) _______-_______ Alt. Phone: (_______) _______-________
Cell Phone: (_______) _______-_______ Alt. Phone: (_______) _______-________
Enroll Date: _________________________ Birth Date: ________________________
Enroll Date: _________________________ Birth Date: ________________________
Email: _______________________________________________________________
Email: _______________________________________________________________
Academic Program(s) of Interest: _________________________________________
Academic Program(s) of Interest: _________________________________________
_____________________________________________________________________
_____________________________________________________________________
Select One: Phone
Electronic Other
In Person
Select One (where did prospect inquire):
Admissions and Guidance Office - Admissions Applied Science/Engineering Tech Div. - ASET Business Division - Business CCS - Lifelong Learning CCS - Workforce Development Computer Labs Financial Aid Office - F.A. Health Sciences Division - H.S. Humanities/Social Sciences Division - Sci./Math Learning Assistance Lab - Disability Services
Select One:
Former/Returning
Select One:
New Current
Phone
Marketing and Communications Office
MKTG./Comm. Off Campus Recruiting Visit - Description Off Campus Event - Description On Campus Event - Description Science/Mathematics Division - Sci./Math Switchboard/Information Desk Testing Center - RCTC Upward Bound Whitman Center - Whitman Other
Inquiry needs to be directed to the following area for follow up.
Admissions and Guidance Office Applied Science/Engineering Technical Division Bookstore Business Division Completed E-Learning Eastern Michigan University Office Financial Aid Office Fitness Center Health Sciences Division Humanities/Social Sciences Division Learning Assistance Lab
Lifelong Learning Registrar/Records Office Science/Mathematics Division Siena Heights University Office Student Government Switchboard/Information Desk Testing Center Tutoring Services Veterans Information Workforce Development Writing Center Other
Electronic Other
In Person
Select One (where did prospect inquire):
Admissions and Guidance Office - Admissions Applied Science/Engineering Tech Div. - ASET Business Division - Business CCS - Lifelong Learning CCS - Workforce Development Computer Labs Financial Aid Office - F.A. Health Sciences Division - H.S. Humanities/Social Sciences Division - Sci./Math Learning Assistance Lab - Disability Services
Select One:
Former/Returning New Current
Marketing and Communications Office
MKTG./Comm. Off Campus Recruiting Visit - Description Off Campus Event - Description On Campus Event - Description Science/Mathematics Division - Sci./Math Switchboard/Information Desk Testing Center - RCTC Upward Bound Whitman Center - Whitman Other
Inquiry needs to be directed to the following area for follow up.
Admissions and Guidance Office Applied Science/Engineering Technical Division Bookstore Business Division Completed E-Learning Eastern Michigan University Office Financial Aid Office Fitness Center Health Sciences Division Humanities/Social Sciences Division Learning Assistance Lab
Lifelong Learning Registrar/Records Office Science/Mathematics Division Siena Heights University Office Student Government Switchboard/Information Desk Testing Center Tutoring Services Veterans Information Workforce Development Writing Center Other
Notes: ______________________________________________________________
Notes: ______________________________________________________________
____________________________________________________________________
____________________________________________________________________