Online Experience Western Reservation

To make a reservation for the Experience Western Event please fill out the form below and click the Reserve button. Your information will be sent to the Undergraduate Admissions Office and you will be sent an email containing more information regarding your overnight visit.

April 19 - 20

This event is limited to 100 seniors who have been accepted to Western Illinois University for the Fall 2015. Reservations for this event close on Tuesday, March 31th. You are welcome to register for a daily visit (which does not include an overnight component) anytime. If you have any questions about the event or reservation form please contact the Admissions Office at 309-298-3157 or admissions@wiu.edu.

Student's Information

  1. Registration Dates


  2. Student's Name
    First Name: Middle Initial: Last Name:







  3. Gender









  4. Emergency Contact Number
    ( ) -



  5. Enter none if you don't have any food allergies.

  6. Street Address










  7. -







  8. Cell Number
    ( ) -


  9. Ex: 01/07/1990

  10. Anticipated Major


  11. Most Recently Attended School