State law requires students born on or after January 1, 1957, who enter Illinois colleges to provide proof of immunization against the diseases of Measles, Mumps, Rubella, Tetanus and Diphtheria. Proof of immunity can be provided by having your health care provider complete the SIUE immunization form or by attaching a copy of a certified school immunization, military record, or child health immunization record to the SIUE form with Part I of that form completed. Return the forms to University Health Service, Box 1700, Southern Illinois University Edwardsville, Edwardsville, IL 62026-1700. Blank forms may be obtained in the
University Health Service
. Failure to return the completed form will make it impossible for you to register for the next term. A $25.00 fee is charged to newly enrolled students.