L&S Academic short form

* Denotes Required

First Name *

Last Name *

Email Address *

Which best describes you as a student? *

Birthdate *

I am interested in attending (select all that apply): *

Milwaukee

Waukesha

My anticipated entry term is: *

My program of interest is: *

Please list any other programs or certificates you are interested in or any questions you have. We will respond shortly!