Information Request Form

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Thank you for your interest in LIU Brooklyn! Please fill out the form below. Click "Request More Information" and the Admissions Office will send you information by mail.

First Name:

Last Name:

Address 1:

Address 2:
(Apartment Number)

City:

State:

ZIP/Postal Code:

Country:

 

Citizenship Country

Phone:
(Including Area Code)

I'll be entering as:

 

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I plan to begin my studies:

 

Name of Most Recent School:

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School Code:

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Date Graduated:
(or Anticipated Date of Graduation):

Intended Major:

 

Email Address:

Re-type Email:

 

How did you become interested in LIU?

If you selected other please specify:

Please explain your request:

Have you ever or do you currently serve
in the United States Military?

Has your parent or spouse served in
United States Military since 9/11/2001?

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