Personal Information

First Name*

Middle Name

Last Name*

Campus*
If you are not associated with a specific campus, please select “Indiana University.”
Select IU Bloomington IUPUI IU East IU Kokomo IU Northwest IU South Bend IU Southeast IPFW IUPUC Indiana University

Relationship to IU*

Alumnus

Faculty

Staff

Student

Friend of IU

Contact Information

E-mail*
Your E-mail address will not be shared with outside parties and will only be used to contact you about IU-related matters.

Phone
( ) -

Home Address

Your home address is needed to match you with your local legislative districts.

Street*

City*

State*
Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip*

Transportation

Will you need transportation from your campus?
(does not apply to IUPUI)

Yes

No

HHE Membership

Are you a member of HHE?

Yes

No

If you are not a member of HHE, would you like to become one?
Membership is free.

Yes

No