Surgical Tech Registration Form

Emergency Contact

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High School Information

Please provide the names of people in your immediate family who have attended the University.

Extracurricular, Personal and Volunteer Activities

List your organizations, position, description of the activity, and hours per week of involvement.
List each, a description, the level, and number of years of involvement.
List the type of work, your role, and hours per week of involvement.
List the job, your title, description, hours per week, and dates of employment.
Click or drag a file to this area to upload.

For Non-U.S. Citizens Only

Click or drag a file to this area to upload.

Agreement

I understand that this application is for admission only for the term indicated. I agree that I am bound by the University’s regulations concerning application deadlines and admission requirements. I agree to the release of any transcripts and test scores to this institution, including any SAT, Achievement Test, and ACT score reports. I certify that this information is complete and accurate. I understand that making false or fraudulent statements within this application or residency statement will result in disciplinary action, denial of admission and invalidation of credit or degrees earned. If admitted, I agree to abide by the policies of the Board of Regents and the rules and regulations of the University. Should any information change prior to my entry into the University, I will notify the Office of Admissions. I understand that the application fee I submit with this application is a non-refundable fee.