UIU Online Information Request Form

Request Information

Upper Iowa University
Online Program

Please Note: For applicants who do not use English as their primary language, an acceptable TOEFL score is 570 for the paper version and 230 for the electronic version.

To: Upper Iowa University Online Program,
Please send me information regarding the following degree program and for the concentrations / majors indicated.

MBA Program - Emphasis in:	MPA Program - Emphasis in:
Accounting Corporate Financial Management Global Business Human Resource Management Organizational Development Quality Management	Homeland Security Human and Health Services Justice Administration Public Personnel Management
Undergraduate Program Majors
AccountingManagement Business AdministrationMarketing Criminal JusticePublic Administration (PA) Emergency and Disaster ManagementPA - Fire Science Emphasis FinancePA - Law Enforcement Emphasis Health Services AdministrationPsychology Human Resource ManagementSocial Science Human ServicesTechnology and Information Management

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First Name: *
Last Name : *
Address:*
Address (cont'd):
City: *
State/Province: *
State/Province:	(for other countries)
Zip /Postal Code: *
Country: *
Day Telephone: *	(###-###-####)
Evening Telephone:	(###-###-####)
E-mail: *	(abc@xyz.com)
Confirm E-Mail: *	(abc@xyz.com)
Date of Birth:
Gender:	MaleFemale
Bachelor's Degree Awarded: (e.g. 2006)
Last College/University attended:
Expected Start Date
At the time of your expected Start Date, what will be your highest level of education: *
GMAT Score:
Undergraduate GPA:
Years of Business Experience:
Additional Questions or Comments:

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