Visiting Student Application

Type of Application*
New End Date
Name*
Date of Birth*
Gender*
Are you a U.S. Citizen or Permanent Resident?*
Mailing Address
Home Address
By checking this box, you acknowledge that your visiting student records are subject to the Family Educational Rights and Privacy Act (FERPA). Your acknowledgement of this statement, and signature on this form, permits UT Health San Antonio to exchange educational records relevant to your visit at UT Health San Antonio with your home institution, to include academic related information. Exchange of visiting student records under this agreement will not require a separate consent.*
Use your mouse or finger to draw your signature above

Part II: (required) To be Completed by Sponsoring Department

The applicant is currently enrolled at another institution of higher education?*
If the applicant is in high school, they have been approved by The Office of Recruitment and Science Outreach*
The applicant is not a student at UT Health Science Center San Antonio*
The applicant is not receiving payment/wages for this experience*
The Sponsoring Department and Visiting Student applicant have reviewed the Visiting Student Policy (HOP 14.2.2) and Attestation Agreement and are aware of the requirements that must be met prior to starting the visit.*

Visiting Student Policy (HOP 14.2.2)

Attestation Agreement


If the applicant meets the criteria above, they can be processed as a Visiting Student by the Office of the University Registrar. If they do not meet the criteria above, they are not processed as a Visiting Student by our office and cannot use this application.


Start Date of Visit (Dates must be exact and cannot be over a year at a time)*
End Date of Visit (Dates must be exact and cannot be over a year at a time)*

For All Visiting Students:

All Items in this area must be completed for the application to be accepted.

For Visiting Students Receiving Credit:

For Minors

Payment

Who is paying the application fee?

For International Visiting Students:

Application Payment

Received Payment *
Process Complete and all Data Entered into the appropriate System*
Date and Time of completion*
: