Western Illinois University

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State: Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia 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 American Samoa Guam Northern Mariana Islands Puerto Rico United States Minor Outlying Islands Virgin Islands Outside Of USA

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Public Act 102-0214 requires that the Board of Trustees of each public university in the state, upon a student declaring or changing their academic major or program of study, provide the student with an Occupational Outlook Report associated with that major.

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* Semester: Fall (August) Spring (January) Summer (July)

* Year: 2024 2025 2026 2027 2028

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* Criminal Record Disclosure Policy

Western Illinois University is committed to maintaining a safe and positive environment for all members of the University community. Therefore, you are required to disclose information regarding your criminal or disciplinary background.

A) Have you ever been convicted of, or been placed on court supervision for any criminal offense? (This does not include routine traffic offenses)

B) Do you have any criminal charges pending against you?

C) Have you ever been dismissed, or withdrawn while charges were pending from any educational institution (including but not limited to high school or college) for any offense involving violence or the threat of violence?

If you answered "Yes" to any of the questions above, please submit a description of the incident(s), including name, date of birth, date of incident(s), location of incident(s), name of arresting agency(s) as well as any additional relevant documentation. Additionally, please request the Circuit Clerk of the Court(s) in which the order of conviction(s) was entered and forward these record(s) to:

Western Illinois University, School of Graduate Studies, ATTN: Campus Violence Prevention Enrollment Committee, 1 University Circle, Macomb IL 61455. These cases will be reviewed prior to a reentry decision being made. Such disclosures do not automatically disqualify an applicant.

This form must be signed and dated by the applicant before action can be taken. I understand that withholding information requested on this form or giving false information may make me ineligible for reentry to the university or subject to dismissal. I certify that the information provided on this form is correct and complete.

By signing this I also certify that I have read, and will adhere to all the components of the Criminal Record Disclosure Policy as stated.

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