WesCard
Application

Graduate Liberal Studies Program
284 High Street
Middletown, CT  06457
Phone (860) 685-2900
Fax (860) 685-2901
Photo identification card application form


To receive your Wesleyan University Photo Identification card (“WesCard”), please complete this form and submit it to the address below.  If you have questions, please contact the WesCard office at (860) 685-5300.

Division of Study:   

   Graduate Liberal Studies Program

WesID:   

   ___ ___ ___ ___ ___ ___

First Name:   

 

Middle Name:   

 

Last Name:   

 

Mailing Address:   

 

Mailing Address:   

 

City:   

 

State and Zip:   

 

Date:   

 

Signature:   

 

Is your photo enclosed?   

    Yes

Is your self-addressed,   
stamped envelope enclosed?   

    Yes

Send this completed form, with your color 2”x2” passport photo and a self-addressed, stamped (first class letter rate) envelope, to:

WesCard Office, Wesleyan University, Room 111 North College, Middletown, CT  06459