Information Request Form

I'm interested in more information about the University Teaching Program

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	Brochure		Vietnam Video (VHS)		China Video (VHS)

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How do you prefer to receive follow-up letters? Email Regular Mail

What is the ONE thing that best describes how you FIRST heard about ELIC/University Teaching Program? (select one) *
	Radio	Passion/One-Day Conference	Urbana Conference
	Poster	World Magazine	Crosswalk.com Email
	Campus Outreach	Christianity Today Magazine	ELIC Event in My Area
	ELIC Rep. on Campus	Discipleship Journal Magazine	Internet Link
	Friend/Family Member	Tomorrow's Christian Graduate Magazine	Internet Search Engine
	Professor/Advisor - Specify Name:	From an ELIC Alum - Specify Name:	Other - Specify:

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