Maverick Experience

Your Info

First/Given Name*

Last/Family Name*

Preferred Name

Birthdate*

Contact Info

Email Address*

Cell Phone

Would you like to receive text messages from UTA including event reminders?

Yes

Mailing Address*

Country

Street

City

Region

Postal Code

Academic Info

Which best describes you?*

What would you like to study?*

When do you plan to start classes?*

What is your current or most recently attended high school?*

What is your current or most-recently attended college?*

Family Member Information

Would you like to share family member information?

Yes

This person is your: *

First/Given Name*

Last/Family Name*

Email Address*

Address

Country

Street

City

Region

Postal Code

Guest Information

Will you be bringing a guest with you?*

Yes

Number of guests (not including you)

Do you or your guest(s) need special accommodations for your visit?

Yes

Special Accommodations (Check all which apply):

Visual Impairment

Hearing Impairment

Sign Language Interpreter

Other

Please describe your request.

Note – Requests are not guaranteed, but we will try to accommodate you as best we can.

Admission Counselor