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.

November 01 - 02

This event is limited to 100 seniors who have been accepted to Western Illinois University for the fall 2016 semester. Reservations for this event close on Monday, October 26, but another Experience Western overnight will be held February 21 - 22. If you have any questions about the event or reservation form please contact the Admissions Office at 309-298-3157 or

* Your registration is NOT COMPLETE until we receive your waiver forms and your $30.00 participation fee. You will NOT be allowed to participate in Experience Western unless admissions staff have the waivers and your $30.00 on file.*

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