Race/Ethnicity Are you a citizen or permanent resident of the (mark all that apply): American Indian or Alaskan Native United States? Asian Yes Black or African American No Native Hawaiian or Other Pacific Islander If applicable, what type of VISA to you have? White Educational Background High School: Current Grade Level: Overall GPA: Graduation Year: International students only: ACT/SAT Score: TOEFL Score: Have you previously attended the University of Utah? Yes No If yes, please answer the following questions: Program Name: Total Credit Hours Earned: Student ID Number (UNID): Parent/Guardian Information Full Name: Last First M.I. Address: Street Address Apartment/Unit # City State ZIP Code Email: I give consent to allow my child to participate in the High School University Program. Yes No I fully support my child in their participation in the High School University Program and believe they are ready to engage in university level courses on a part-time basis. Yes No If please explain why: “no,”
Race/Ethnicity (mark all that apply): American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Are you a citizen or permanent resident of the United States? Yes No If applicable, what type of VISA to you have? Educational Background High School: Current Grade Level: Overall GPA: Graduation Year: International students only: ACT/SAT Score: TOEFL Score: Have you previously attended the University of Utah? Yes No If yes, please answer the following questions: Program Name: Total Credit Hours Earned: Student ID Number (UNID): Parent/Guardian Information Full Name: Last First M.I. Address: Street Address Apartment/Unit # City State ZIP Code Email: I give consent to allow my child to participate in the High School University Program. Yes No I fully support my child in their participation in the High School University Program and believe they are ready to engage in university level courses on a part-time basis. Yes No If “no,” please explain why:
HSUP_application_2016.docx