Indiana University

Request for Application Packet

Please fill out the form below to notify our Admissions Office of your interest in receiving an application packet. When you have all of the information entered, click on the "Submit Request" button. If you click on the "Clear Form" button, all of the information you entered will be cleared from this form. If you are requesting more than one application packet, after sending one request, please click on the "Clear Form" button to entirely clear the form, and reenter all information to assure the accuracy of the transmission.

Application Request Form

First Name:
Middle Initial:
Last Name:
Address:
 
City:
State/Province:
Zip/Postal Code:
Country [if not USA]:
Telephone:
E-Mail:
Gender* (Optional):
Male
Female
Ethnic Group* (Optional)
Please check all that apply:		 American Indian/Alaskan Native
Asian/Pacific Islander
Black/African American
Canadian Aboriginal
Caucasian/White
Chicano/Mexican American
Hispanic/Latino
Puerto Rican
Other
Year You Intend to Start:

   

*This information is requested solely for the purpose of determining compliance with Federal Civil rights law, and your response will not affect consideration of your application. By providing this information, you will assist us in assuring that this program is administered in a nondiscriminatory manner.

If you wish to inform Indiana University School of Law-Indianapolis of a disability, or wish to receive information about auxiliary aids and services for students with phys- ical, mental, or learning disabilities, contact the Office of Adaptive Educational Services at http://life.iupui.edu/aes, or call (317) 274-3241 (voice) or (317) 278-2050 (TDD).

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