Degree Completion Programs Information Request

Personal Information

First Name

Last Name

Email Address (personal, non-school email address)

Cell Phone

Date of Birth (collected to prevent the creation of duplicate records)

Academic Program

I am interested in studying:

I plan to start classes in:

By submitting this form, you are providing your express consent authorizing Dominican University and its representatives to contact you by email, text, and phone (including use of an automatic dialing system) at the email and phone number above. Consent is needed to contact you but is not a requirement to enroll at Dominican. Standard text messaging and/or data rates may apply.