Student Name:

Student Major/Field of Study:

Student E-Mail:

Student Number (Exclude "X"):

Phone Number to be reached at:

Preferred time of the day:
Morning     Afternoon  

Preferred Day of the Week:
Monday     Tuesday     Wednesday     Thursday     Friday

Request an appointment with:
Not Sure Eric Bennett Michelle Detering Alan Sorrells Saiid Mahjoory Tonjala Eaton Ana Woehr Lisa Alexander Judy Leventhal Rafeeq McGiveron Carol Mader Eva Menefee

Questions or Comments:

You will be contacted via e-mail with a scheduled appointment based on your preferred times. If, for any reason, that time does that work for you, simply give us a call on our appointment line: 517-483-1904.   

We are currently not taking requests from this request form.
Please call the office at 517-483-1904 to schedule an appointment. Thank you.