Southeast Missouri State University

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You're on your way to becoming a Southeast Redhawk! Please enter the information requested in the following sections. Fields with a red asterisk (*) are required and must be completed before you can submit the form.

Contact Information

First Name*First letter of the First Name must be a capital letter

First letter of the First Name must be a capital letter

Last Name*First letter of the Last Name must be a capital letter

First letter of the Last Name must be a capital letter

Preferred First NameFirst letter of the Preferred First Name must be a capital letter

First letter of the Preferred First Name must be a capital letter

Birth DateMM/DD/YYYY

MM/DD/YYYY

Citizenship Status

Email Address*

Confirm Email Address*

Home PhoneIf international, foreign/overseas home phone.

If international, foreign/overseas home phone.

Cell PhoneProviding a cell phone gives Southeast permission to send you text messages. Standard messaging fees may apply, and you can opt out at any time.

Providing a cell phone gives Southeast permission to send you text messages. Standard messaging fees may apply, and you can opt out at any time.

Preferred Method of Contact

Check if address is outside of U.S. or Canada

Address

City

State/Province

ZIP/Postal Code

Province/State and Postal CodeEnter the 3rd line of the foreign address as it appears on the mailing label (typically province and postal code).

Enter the 3rd line of the foreign address as it appears on the mailing label (typically province and postal code).

Country

Parent/Emergency Contact Information

First Name

Last Name

Email Address

High School Information (Required)

High School Information 1

U.S. High SchoolIf you attend/attended a U.S. high school, conduct your search here. After finding your school in the search, choose the SELECT button. NOTE: If you can't find your U.S. school using the search, try spelling out the city instead of using the abbreviation (i.e. St. Louis is Saint Louis). You can also try leaving the city BLANK.

If you attend/attended a U.S. high school, conduct your search here. After finding your school in the search, choose the SELECT button. NOTE: If you can't find your U.S. school using the search, try spelling out the city instead of using the abbreviation (i.e. St. Louis is Saint Louis). You can also try leaving the city BLANK.

Organization Name (full or partial)

Country

State/Province

City (full or partial)

Unlisted U.S. or Overseas High School Name and AddressIf you can't find your U.S. school using the search above, CLEAR the information above and then type the high school name and address below. If you attend/attended a secondary school overseas, type the name and address of your school below.

If you can't find your U.S. school using the search above, CLEAR the information above and then type the high school name and address below. If you attend/attended a secondary school overseas, type the name and address of your school below.

Home Schooled

Have you graduated or do you expect to graduate?

Graduation Month

Graduation Year

Did or will you receive your GED/HSE?GED/HSE is high school equivalency for those who won't graduate from high school.

GED/HSE is high school equivalency for those who won't graduate from high school.

College Information

+ Add College Academic History

Entry Term*

Academic Level*

Academic Program

Account Information

Password:

Password must be at least 8 characters and include one upper case, one lower case, and one number.

Confirm Password:

Password must be at least 8 characters and include one upper case, one lower case, and one number.

Password Question*If you forget your password, we will ask you this question in order to reset it.

If you forget your password, we will ask you this question in order to reset it.

Password Answer*If you forget your password, you must provide this answer in order to reset it.

If you forget your password, you must provide this answer in order to reset it.

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