The University of Texas at Austin
PhD in Translational Science
Concurrent Enrollment at UTSA, UTHSCSA and/or UTHSC-Houston
STEP I (to be completed by the UT Program Coordinator)
Semester:
UT Austin EID:
UT Student’s Name:
This student is authorized to take courses in the PhD Translational Science Program at the designated
institution.
Designated host institution for course work:
UT Program Coordinator:
Date:
STEP II (to be completed by the UT Registrar’s office, and GIAC if international)
U.S. Citizen?
YES
Visa Type:
NO
(If not a U.S. citizen or permanent resident, this form must be signed by an international advisor in GIAC)
International Advisor:
Date:
Tuition Status:
Tuition Waiver Eligibility:
YES
NO
Registrar:
Rule:
Date:
STEP III (to be completed by the UT student)
Course No.
Course Title
SCH
Program Coordinator Approval
Date
I request that my grades for the above course(s) be forwarded to the Office of the Registrar at the
University of Texas at Austin after the completion of the course(s).
Student:
Students need to give copies to:
 Home Institution (UT Austin)
 Host Institution(s)
 Self
Date: