UIC Athletics

Former Flames Athletes and Coaches! Please stay in touch with University of Illinois at Chicago Athletics by filling out this questionnaire. The information requested on this form is very important to us, so please be as thorough as possible.

Please fill in the following:

Your full name (First, Last, Maiden)

Street Address

City, State

Zip Code

Daytime Phone

Evening Phone

E-Mail Address

Fax Number

Occupation

Hometown

High School

What sport(s) did you participate in/coach at UIC?

Years participated/coached (e.g. 1969-73)

If you played a sport at UIC, who was your coach?

Did you graduate from UIC?

Would you like to receive schedules and ticket information for any athletic sport at UIC?

If yes, which sport(s)?

Are you currently a member of the UIC Big Red Fund?

Any additional information about yourself:

Verify characters: