Alumni Student Referral Form

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Alumni Student Referral Form

Thank you for referring a prospective student to Rockford University. By completing the information below you ensure that your student will be contacted by the Admission Office and, should they enroll, receive a $500 scholarship toward their first year’s tuition. Completing the information will also allow us to properly thank you for believing in Rockford University’s Rock Solid education and experience.

Name of perspective student*
First Last
Address of Prospective Student
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email of Prospective Student*
Phone of Prospective Student*
Intended major or special interests of Prospective Student
High school or College Prospective Student is Currently Attending
Name of Alum*
First Last
Graduation Year of Alum*
Please enter a number greater than or equal to 4.
Email of Alum*
Phone of Alum*
Alum’s Relationship to student*