IET Information Request Form, Southeast Missouri State University

IET Information Request Form

Please complete this form for more information on the Southeast Missouri State University 2+2 and 2+2+2 programs.

Name:
E-mail:
Date of Birth:
Street Address:
City:
State:
Zip Code:
Phone Number:
School:
Grade:

If you would like any specific information about our department, please type it below:

Questions

Why are you interested in participating in this program?

What do you hope to accomplish?

How did you hear about this program?

Where do you work and what is your current job?

What kind of job would you like to have when you get out of school?

If you would like to contact us:

Department of Industrial and Engineering Technology
Southeast Missouri State University
St. Louis Community College Florissant Valley
3400 Pershall Road
St. Louis, Mo. 63135

Phone: (314) 513-4311
Fax: (314) 513-4718
E-mail: brichardson@semo.edu