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General Information
Your Name
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First Name
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Last Name
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UIW ID
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UIW Email Address
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Example: _______@student.uiwtx.edu
Classification
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Freshman
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Have you applied for graduation
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Anticipated date of Graduation (semester/year)
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If you have not applied to graduate, please indicate the term you anticipate completing your studies. If you have applied, please indicate the semester of graduation.
Are you a student athlete?
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Your Advisor's Name
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Major
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Institution Information
College/University I am requesting to take course(s) at
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Total Hours Requested
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Semester and Year of Intended Enrollment
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Course Information
Course Number (1)
*
Course Title (1)
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Equivalent at UIW (1)
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What UIW course will this transfer in as?
What requirement will this satisfy? (1)
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Core
Major
Minor
Elective
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Course Number (2)
Course Title (2)
Equivalent at UIW (2)
What UIW course will this transfer in as?
What requirement will this satisfy? (2)
Core
Major
Minor
Elective
Other
Course Number (3)
Course Title 3
Equivalent at UIW (3)
What UIW course will this transfer in as?
What requirement will this satisfy? (3)
Core
Major
Minor
Elective
Other
Course Number (4)
Course Title (4)
Equivalent at UIW (4)
What UIW course will this transfer in as?
What requirement will this satisfy? (4)
Core
Major
Minor
Elective
Other
Additional Student Information
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