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Information Request


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Information Thank you for your interest in learning more about our programs at Eastern New Mexico University!

Required - indicates a required field.
Information Please enter your name as it appears on your legal government documents (passport, driver's license etc.). If you prefer a different name you can enter it in the nickname section.

Prospect Name
First Name: Required
Middle Name:
Last Name: Required

Information Where should we send your mail? The address you list will be used throughout the admission process.

Primary Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
State or Province:
ZIP or Postal Code:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Information Please choose the program you are interested in attending. If interested in leveling courses in communicative disorders then please select CDIS Leveling.

Prospect Major

Information Please tell us how you learned about the program you are interested in. To select multiple materials use Ctrl+Click for PC and Command+Click for Mac.

How Prospect Learned About Us
How I Learned About :

Information When do you plan to start?

Prospect Entry Term
Term of Entry:Required

Information Please enter your Birthday.

Prospect Birthdate
Date of Birth:Required Month Day Year (YYYY)

Information What email would you like to receive pertinent information about ENMU?

E-Mail Address
E-mail Address:Required
Verify E-mail Address:Required

Information Please enter information about your ethnicity/race. Please note this is an optional field but is helpful to the institution.

Prospect Ethnicity/Race

Note What is your ethnicity?

Hispanic or Latino
Not Hispanic or Latino

Note Select one or more races to indicate what you consider yourself to be.

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
American Indian or Alaska Native
Black or African American
Native Hawaiian and Other Pacific Islander

Information Please select a gender.

Prospect Gender
Gender:Required Male Female Not Specified

Information If you hold citizenship in a country other than the United States please complete the information below.

Prospect International Info
Nation of Citizenship:
Nation of Birth:
Native Language:
Foreign SSN:

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