SMMC Financial Coaching Intake Form

Appointment Request

Please complete the contact information below & other questions on the following page to prepare for your financial coaching session.

Please allow 1-3 business days for a response. It's unlikely that we are able to accommodate same day requests.

Requests are processed on a first come, first served basis. However, current University of Illinois System students take priority for scheduling appointments.

1. UIN: (9 digit number) answer must be a university ID like 612345678

2. Email: answer must be an email address

3. First Name:

4. Last Name:

5. University:

Enter text for question 5 other

SMMC Financial Coaching Intake Form

SMMC Financial Coaching Intake Form

Appointment Request

1. UIN: (9 digit number) answer must be a university ID like 612345678

2. Email: answer must be an email address

3. First Name:

4. Last Name:

5. University:

6. Please choose the option(s) below that best describes you:

7. Program of Study and/or Major:

8. Employment Status: