The University of Texas at Tyler
Undergraduate Transient Approval Form
Complete the entire form. Incomplete forms cannot be processed. Contact Enrollment Services at 903.566.7180 to verify receipt of
form and/or course registration.
STUDENT'S NAME: ________________________________________________________________________________
Last
First
Middle
EMAIL ADDRESS: ___________________________________ PHONE NUMBER: ___________________________
SEMESTER: □ Fall
□ Spring
□ Long Summer □ Summer I
□ Summer II
YEAR: _________________
List the course(s) which you wish to take at UT Tyler. If course has prerequisites, you must supply copies of
official transcripts showing completion of pre-req. Pre-reqs are listed online via myUTTyler.
CALL #
COURSE # SECTION
TITLE
TIME
DAYS
CREDIT
Ex: (50098) Ex: (BIOL 1106)
Ex: (OO1)
HOURS
A completed Transient Application must be on file before registration will be processed.
Please read the following statement and sign.
I understand that I can only register for the course(s) approved herein. I also understand that this approval form
is only for the term and course(s) specified.
Student's Signature: _______________________________________
Date: ________________________
TO BE COMPLETED BY THE STUDENT'S COLLEGE/UNIVERSITY
The above named student is in good academic standing and is eligible and authorized to take the course(s) listed
above during the semester/year named. Transfer credit for these courses will be acceptable upon successful
completion of the course work and upon the receipt of an official transcript.
College/University: __________________________________
FICE Number: __________________
Mailing Address: ___________________________________________________________________________
City: _______________________________________ State:__________________ Zip Code: ______________
Name of Certifying Official: ___________________________________ Title: __________________________
Phone Number: _____________________________________________FAX: __________________________
Signature: __________________________________________________Date: __________________________
Send completed form to:
UT Tyler; Enrollment Services; 3900 University Blvd; Tyler, TX 75799 or FAX to 903.566.7183.
Information Laws and Practices: With few exceptions, you are entitled on your request to be informed about the information The University of Texas at Tyler
collects about you. Under Sections 552.021 and 552.023 of the Texas Government Code, you are entitled to received and review the information. Under Section
559.004 of the Texas Government Code, you are entitled to have The University of Texas at Tyler correct information about you that is held by us and that is incorrect,
in accordance with the procedures set forth in The University of Texas System Business Procedures Memorandum 32. The information that The University of Texas at
Tyler collects will be retained and maintained as required by Texas records retention laws. (Sections 441.180 et seq. of the Texas Government Code) and rules.
Different types of information are kept for different periods of time. Social Security Number: Disclosure of your Social Security Number (“SSN”) is requested for the
student records system of The University of Texas at Tyler (the “University”) and for compliance with Federal and State reporting requirements. Federal law requires
that you provide your SSN if you are applying for financial aid. Although an SSN is not required for admission to the University, failure to provide your SSN may
result in delays in processing your application or in the University’s inability to match your application with transcripts, test scores, and other materials. Student SSNs
are maintained and used by the University for financial aid, internal verification, and administrative purposes, and for reports to Federal and State agencies as required
by law. The privacy and confidentiality of student records is protected by law and the University will not disclose your SSN without your consent for any other
purposes except as allowed by law.