IYS Student Registration Form

Contact Information

Last Name *

First Name *

Middle Initial

Primary Contact Number *

Class Standing *

GPA * If current GPA is not available, write your high school GPA. Format: 3.00

Do you live in the First Street Residence Hall? * YesNo

Suite number *

Room letter *

Address

Street Address *

Address continued

City *

State

Zip *

General Questions

What is your major?

What is your minor? (if any)

What are some of your hobbies?

What are your goals for this academic year?

Do you have a UM Flint faculty or staff member mentor? * YesNo

Please share their name

University of Michigan-Flint