LTEC Intent to Apply Survey
Please complete the survey below.
Note: This is not the official application form for the Graduate Division. Please refer to the following website to obtain one: http://www.manoa.hawaii.edu/graduate/content/submitting-your-application
1. Name:(Last, First) *
Your answer
2. Home address:(include: City, Island, and Country) *
Your answer
3. Home Phone: *
Your answer
4. Work Phone:
Your answer
5. Cell Phone:
Your answer
7. UH email:
Your answer
9. UH ID # ( if already assigned):
Your answer
8. Other email: *
Your answer
10. Program Preference: *
Transfer Credit
If you checked COLT or TeachTech, please indicate any LTEC electives taken that you believe may count toward the certificate. Please state the course number and name as well as the semester and year taken
Your answer
11. Have you ever applied for this program before? *
Required
When?
Your answer
12. Do you have a UH position that potentially provides a tuition waiver? *
13. Funding for education: *
If confirmed scholarship, please list:
Your answer
14. Where did you learn about the program? *
Required
Submit
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