Connect | Entry Form

Personal Info

First name

As it appears on your passport, driver's license, or I-Card

Last name

Preferred first name

Leave blank if same as first name

NetID

If you have not yet been assigned a netid, leave blank

UIN

9-digit number, found on your I-Card

Email

Please use Illinois email if you have one

UIUC Contact Info

Preferred Campus Address

Leave blank if preferred address is IGB

Office number

Non-IGB campus address room number

Building

Non-IGB campus address building

Other address

UIUC home department/unit

Other department

IGB Appointment Info

IGB Office/Lab/Cubicle #

Office phone #

Office work only?

Check this box if you will not be working in a lab

Theme/Group

Position type

Faculty Sponsor

Supervisor

Start date

End date

If no end date is known, leave blank

Captcha

When you click submit, your entry form will be sent to staff members in your theme for approval. Once your entry form is approved, you will receive a welcome email with helpful information and next steps.

IGB Entry Request Form