Application Workshop at U of A Scottsdale Center

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Student Information

First Name*

Preferred Name

Last Name*

Birthdate*

Email Address*

Cell Phone*

I give permission to University of Arizona to send me updates related to the event I am registering for, as well as additional information that may be relevant to me, via text messaging. (Standard message charges apply.)

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Please select your school from the drop down menu, if possible.

Current or Most Recently Attended High School/College*

Do you require any disability-related accommodations?* (All virtual sessions will include live transcription and closed captioning.)

Yes

No

Please list those accommodations here:

Student's Enrollment Information

Entering As*

First-Year

Transfer

Readmit

Non-Degree Seeking

Intended Start Term*

Parent Signature

Parent or Legal Guardian Attestation
I am the parent or legal guardian of the student named above. I consent to providing this information and confirm that I am the person submitting this form.

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Welcome

Application Workshop at U of A Scottsdale Center