Refer a Student

• Student Name

  Student Name * First Last
• Student Street Address
• Student City, State, Zip *
• Phone number where student can be reached

  Phone number where student can be reached - ### - ### ####
• Student Email *
• Student High School Graduation Year *
• Your Name

  Your Name * First Last
• Your Email *
• What is your relationship to the student?
• Your relationship to EMU
  Your relationship to EMU

  Alumnus Student Faculty/Staff EMU Ambassador Other Other
• Comments