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GENERAL/CONTACT INFORMATION

Student First Name:
Student Last Name:
Primary Email:
Primary Phone:
School Mailing Address:
Address 2:
City:
State:
Zip Code:
Birthdate:	[MM/DD/YYYY]
Gender:
Race/Ethnicity:
*If other, please add other race/ethnicity here:

SCHOOL/DEGREE INFORMATION

School Name:

School Campus Location:

Major:

*If other, please add other Major here:

Minor:

*If other, please add other Minor here:

Degree Type:

Graduate

Undergraduate*

*If Undergraduate, what Academic Year?:

*If other, please add other Academic Year here:

Anticipated Graduation Date:

[MM/DD/YYYY]

PARTNERSHIP OPTIONS

You will continue to have access to your Choose Chicago Student Partnership account and all of its resources for six months past your graduation.
Partnership Type:

TERMS OF AGREEMENT

Student Partnership with Choose Chicago is held in the name of the student entered under the "Partner Information" section of this application. Any benefits of this partnership such as Choose Chicago reports, communications, and events are limited to that name. Student Partnership benefits do not begin until receipt of completed online application. Online applications are approved within 48 business hours unless otherwise noted.

Choose Chicago reserves the absolute right to cancel an existing Student Partnership or reject a Student Partnership Application that it, in its sole judgment, deems inappropriate.

I have read, understood, and accept the above TERMS OF AGREEMENT

Verification:

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