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The TEXAS SEMESTER Application

* Required

  First Name: *  
  Middle Name:  
  Last Name:*  
  Date of Birth:  
  Social Security No. (optional)  
  Sex:
 
  Street or Box No.  
  City:  
  State:  
  Zip Code:  
  Valid Until:  
  Telephone:  
  Email:*  
  Permanent Address (if different from above)    
  Street or Box No.  
  City:  
  State:  
  Valid Until:  
  Telephone:  
  Email:  
  Home College or University:  
  Present Academic Standing:



 
  Explain:  
  Cumulative G.P.A.:  
  Academic Major(s):  
  Academic Minor(s)  
  Are you/Have you ever been on academic probation:
 
  Explain:  
  Are you/Have you ever been on disciplinary probation?
 
  Explain:  
  Learned of The Texas Semester program from:  
 
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