Early Start Application

Student Information

First Name*

Preferred Name

Middle Name*

Last Name/Surname*

Social Security Number (please omit dashes)*

Date of Birth*

Gender*

Female

Male

Undeclared

Contact Information

Permanent Address*

Country

Street

City

Region

Postal Code

Student Personal Email*
(please do not use your high school email address, as external emails can be blocked)

Student Cell Phone*
(International students, please add a "+" before the country code (example, +91))

Academic Information

High School

High School CEEB (Hidden)

High School Level of Study (Hidden)

What year do you graduate high school?

If going to college, what academic year do you plan to start?

If going to college, what semester do you plan to start?

Enrollment Classification*

Primary Academic Interest*

Department (hidden)

Would you like to receive text messages, at this number, from Indiana Tech?

Yes

No

Early Start Information

Have you been enrolled in Early Start classes in the past?

Year

Term

Leading Connection (Int'l hard-code)

Parent Information

Including parent information is REQUIRED for all Early Start Students.

Parent Type

Parent First Name

Parent Last Name

Parent Mobile Number

Parent Email Address

Entrance Code

Early Start

Early Start Stage

Applied - Early Start

Early Start Application - Fall 2026