Student RFI

What type of student are you?*

I am a*

Freshman

Transfer

Biographical Information

First name*

Last (family) name*

Preferred name

Mailing Address

Country

Street

City

Region

Postal Code

Email Address*

Cell/Mobile Number*

Would you like to receive text messages from UT Permian Basin? Data rates may apply.*

Yes

No

Date of Birth*

Sex at birth*

Female

Male

Prefer not to say

Are you applying as an international student?

Yes

No

Current High School or School you graduated from

Current or Final GPA

Expected Graduation Date (MM/YYYY) *

Program(s) of Interest

Most recent College/University attended

Expected Graduation Date (MM/YYYY) *

Program(s) of Interest

Highest Degree

School that Awarded Degree

GPA

Program(s) of Interest*

Non-Degree Classification

Courses you want to take

Proposed Enrollment Date (eg. Fall 2022, Spring 2023, Summer 2023, etc.)

Have questions, comments, or want information about additional programs? Let us know below: