Referral Form

Thank you for referring a student to Indiana Wesleyan University! We are excited to reach out and connect with this student about the quality programs and value of an IWU education at our traditional undergraduate campus in Marion, Indiana.

Please submit the following information to the best of your ability so that we can follow up quickly.

* required fields

STUDENT INFORMATION

Prospective Student's First Name*

Prospective Student's Last Name*

Prospective Student's High School Graduation Year

Please check if any of these applies to the Prospective Student

Parent/Grandparent attended IWU

Student attends a Wesleyan Church

Do you have a phone number, email, both or neither for the prospective student?*

Phone Number

Email

Both

Neither

Prospective Student's Email Address*

Prospective Student's Phone Number*

YOUR (REFERRER) INFORMATION

Your First Name:*

Your Last Name:*

Your Email:*

Your Relationship with the Prospective Student*
(Please select the best fit.)

Do you have any additional referrals to submit? If so, click here to submit this referral and open another.

If you have completed your referral(s), click SUBMIT.

Thank you!