Indiana University search DEMA
Vice President for Diversity, Equity, and Multicultural Affairs
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Destination IU:  Envision - Believe - Achieve
Help DEMA Bring the Best and the Brightest to IU

We appreciate your support of Indiana University and particularly its efforts to increase the diversity and inclusion of students from underrepresented backgrounds. Please complete the Prospective Student Recommendation Form with as much information as possible. You may either complete and submit the online form below or download the form (Microsoft Word file) and send the completed document to the e-mail or mailing address provided on the form.

If you have questions, please contact Philip A. Seabrook, Assistant Vice President for College Readiness Initiatives, at 812-856-5748 or pseabroo@indiana.edu.


Prospective Student Recommendation Form


Recommender's information

First name:
Last name:
E-mail address:
Student's relation to you (e.g., child, grandchild, friend, student):


Student being recommended

First name:
Middle name:
Last name:
E-mail address:
Home address:
City:
State:
Zip:

Date of birth (mm-dd-yyyy):   - -       Gender:   Male   Female       Ethnicity:  

The student is in:   Middle school   High school

High school graduation year:  

Name of student's school:
City:
State:

Additional comments:



Revised: October 13, 2011

Vice President for Diversity, Equity, and Multicultural Affairs
Bryan Hall 115, Bloomington, IN 47405-7000, USA
(812) 856-5700

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