International Information Request

International Information Request

Welcome international students!

Complete the form below to receive information from Parkside.

Returning users can update their information by using the "Login" button and updating any fields on this screen.

* Note: To request information and/or register for an event, fill out the forms below. You will be able to log back in to update your information.All fields marked with an asterisk (*) are required!!!!!!

STUDENT INFORMATION

First Name:

Please enter a valid First Name

Last Name:

Please enter a valid Last Name

Username:

Password (minimum 7 characters):

Email:

CONTACT INFORMATION

Street Address:

Unit#:

City:

State:

Country:

ZIP Code:

Primary Phone (with country code):

Country of Citizenship:

HIGH SCHOOL/COLLEGE DETAILS

Most recent college of attendance, if any:

College Finder

Clear

High School:

High School Finder

Clear

High School Graduation Year:

EDUCATIONAL ASPIRATIONS

Entering as:

Projected Start Term:

Major/Interest Area:

PERSONAL DETAILS

Date of Birth (MM/DD/YYYY):

Race/Ethnicity (Optional, select all that apply):

African American or Black
American Indian, Native American, or Alaska Native
Asian
Latino(a) or Hispanic
Native Hawaiian or Pacific Islander
White
Other Race

D I S C L A I M E R: The data presented on this page is confidential.

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900 Wood Road • P.O. Box 2000 • Kenosha, WI 53141-2000 P 262-595-2345