Pickup Request Form
First and last name (given name and family/surname)
*
WIU student ID number
Country of citizenship
Email address
*
Phone Number
*
-
Area Code
Phone Number
Sex (gender)
Male
Female
Arrival Information
Pickup date
Saturday, August 10
Sunday, August 11
Monday, August 12
Tuesday, August 13
Flight information (airline, flight number, arrival time, departure city)
*
Requesting pickup at
*
Train in Macomb
Airport in Moline, Illinois
What time are you arriving by train?
*
10:58 a.m. (morning)
9:22 p.m. (21:22) (night)
I am not arriving by train
Please upload your flight itineary if possible.
Will you need temporary housing? (someplace before you move into your dorm/apartment)
*
Yes
No
I do not know
Where will you be living?
*
Dormitory
Graduate/Family Housing
Apartment off campus
I don't know
Additional information you would like us to know?
Submit
Should be Empty: