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New York City Seminar

Personal Information

* First Name:		M.I.		* Last Name:
* Address1:
Address2:
* City:		* State		* Zip Code:
* Phone:		* UT EID:
* E-mail:
* College:			* Major:
* Class:
* Gender:	Female	Male

Seminar Information

Choose your first and second seminar choices:

* Choice 1:			* Choice 2:
* Accommodation:
Roomate 1 Request:
Roomate 2 Request:

Emergency Contact Information

Please enter the name, relationship and phone number of who you would like contacted in an emergency:

* Name:
* Relationship:			* Phone:

Account Information

Your UT EID will be your username, please create a password (at least 6 characters):

* Password:
* Re-Type Password: