Early College: Dual Credit and Early Entry

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HS Dual Credit/Early Entry Application

Section 1: Basic Applicant Information
Page 1 of 3
1. 

How did you find out about UTTC’s dual credit programs?

*Required
2. 

Anticipated Academic Enrollment Year:

*Required
3. 

Anticipated Academic Enrollment Term:

*Required
4. 

High School Currently Attending

*Required
5. 

Are you a high school student who is enrolled in the UTTC Monarch Project?

*Required
6. 

High School GPA

*Required
7. 
Legal First Name
*Required, Maximum characters allowed: 30
8. 

Middle Initial

Maximum characters allowed: 30
9. 
Legal Last Name
*Required, Maximum characters allowed: 60
10. 

Preferred First Name (not your nickname)

Maximum characters allowed: 30
11. 

Birth/Maiden Last Name

Maximum characters allowed: 30
12. 
Date of Birth
*Required, Format: mm/dd/yyyy
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13. 

Social Security Number -Please use dashes when entering you SSN (XXX-XX-XXXX)

 

*Required, Format: 123-45-6789
14. 

Gender

15. 

Cell Phone Number

Format: 123-456-7890
16. 

Home Phone Number

*Required, Format: 123-456-7890
17. 

Email Address

Be sure to check your SPAM/Junk folder for uttc.edu emails

*Required, Format: x@x.xx
Residency and Citizenship Status
18. 

US Citizenship Status

*Required
19. 

Country of Citizenship

*Required
20. 

Ethnicity:

*Required
21. 

Race:

Tribal Information
22. 

Are you an enrolled member of a Federally Recognized Tribe?

*Required
23. 
Select your tribal affiliation:
*Required
24. 

Tribal Enrollment Number

Maximum characters allowed: 10
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