UA Scholar Information Session

Congratulations on your UA Scholar Award! Please fill out the form below to attend a UA Scholars info session via Zoom, we look forward to seeing you!

Personal Information

First Name

Last name

Preferred First Name

Date of Birth

Address Information

Country

Mailing Street Line 1

Mailing Street Line 2

Mailing City

Mailing State (US or Can)

Mailing Zip Code (US or Can)

Mailing State/Province

Mailing Postal Code

Contact Information

Mobile Phone

Accept Text Messages?

YesNoText or data rates may apply

Student Information

Anticipated Start Term/Semester

Number of Guests

Current/Most Recent High School

High School Grad Year

High School Name

Session Information

Session

Do you have any questions for the speaker(s)?

Do you have any questions for us?

Contact Information