SROP Student Registration Form

If you have any questions, please contact Joseph Miller, email cicsropcoord@staff.cic.net or phone 217-244-4899.

NOTE: a star (*) indicates questions which require an answer.

Personal Information







  1.     (use 4 digits for year, i.e. "1985")

Where can we contact you during the school year?
  1. (use format 123-456-7890)
CIC recruiters want to know more about you
  1.   
  2.     (use 4 digits for year, i.e. "2011")

Legal
  1. Your registration information will be distributed to CIC SROP universities.

    I authorize the Committee on Institutional Cooperation (CIC) to share my personal and educational data that I provide using this online form. This consent applies to education data that may otherwise be protected under the federal Family Educational Rights and Privacy Act of 1974, as amended, 20 U.S.C. 1232g, also known as FERPA or the Buckley Amendment. This authorization will remain in effect until I rescind it in writing.