Admissions and Housing Assistance Request Form

Admissions and Housing Assistance Services Request:

Please take a moment to fill out this form so we may begin to assist you. Please be sure to provide a detailed description of the difficulty you are having. Please include any names, phone numbers and departments contained in any communications you have received stating that your request for either admission or housing has not been approved. This will allow us to expedite our assistance process.

* Denotes Required Field

First Name:*
Last Name:*
E-mail:*
Phone:*

Preferred Contact Method:	Phone	E-mail
Preferred Contact Time:	Day	Evening

I would like assistance with:*	Admissions
	Housing
	Admissions and Housing

Please take a moment to describe the difficulty you are experiencing. The more detail you provide, the more easily we will be able to offer assistance:*

Thank you for sending this request to the UW-Milwaukee Women's Rugby Staff. We appreciate the opportunity to be of assistance to you!