Transfer Request for Information (On-Campus)

Personal Information

First Name*

Preferred Name*

Last Name*

Student Personal Email*

Date of Birth:*

Gender:*

Female

Male

Undeclared

Contact Information

Permanent Address*

Country

Street

City

Region

Postal Code

Student Cell Phone*

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

Yes

Preferred Method of Contact (Select All That Apply):

Phone

SMS Text

Student Information

Intended Entry Year*

Intended Entry Term*

Primary Academic Interest*

Seondary Academic Interest (if applicable)

How many college/universities have you attended?*
(If you took dual credit in high school, please include/count that in your count of colleges/universities attended)

Most Recent College/University Attended (School 1)*

College/University 2 Attended*

College/University 3 Attended*

College/University 4 Attended*

College/University 5 Attended*

Are you interested in a transfer credit evaluation?*

Yes