Benedictine University

Request Application Form

Request Application Form

Fill out the form below if you would like to recieve application material by mail.

Also check out alternative ways to submit an application:

*Application Type:

*Probable Major or Field of Study:

*First Name:

Middle Name:

*Last Name:

*Phone Number:

Include country code for phone # outside the US.

*E-mail Address:

*Address 1:

Address 2:

*City:

Term of Entry

*Name of the institution you've last attended as a student:

e.g. Naperville North High School, College of DuPage, DePaul University, Vocational School etc.

* USA and Canada addresses:

State/Province:
Zip/Postal Code:

* International addresses:

Postal Code:
Country:

* required field