1 Start 2 Page Break 3 Complete I am applying for * Spring 2020 Fall 2020 Last Name * First Name * Middle Initial Phone * UA Student ID * Local Address (Apt No.) * City/State/Zip * Permanent Address (Apt No) Permanent City/State/Zip UA Email * Alternative Email Have you ever been convicted or pled “No Contest” for any violation of the law other than minor traffic violations? * Yes No Race/Ethnicity - None -African AmericanHispanicAsian American/Pacific IslanderAmerican Indian/Alaskan NativeWhite Current Semester Status * Undergraduate Post-Baccalaureate Are you an international student? * Yes No Please enter the name of the school, grade level and the name of the teacher with which you were placed. (Include all previous placements) * Leave this field blank Next Page >
