Contact Information

First Name*

Last Name*

Preferred First Name

Alternate Last Name

Personal Email*

Birthdate*

Mobile (Cell) Phone*

Mailing Address*

Country

Street

City

Region

Postal Code

Academic Information

WSU Tech Student ID

WSU Tech Entry Term
(Ex. Summer 2023, Fall 2023)

Anticipated Semester of Entry to Wichita State*

Do you plan on getting an Associate of Arts from Wichita State through the Shocker Pathway program?*

If you plan to receive an Associate of Arts from Wichita State through the Shocker Pathway program, please visit https://slate.wichita.edu/register/ShockerPathway to fill out the Shocker Pathway form as well or visit https://wsutech.edu/shockerpathway/ for more information.

If you plan to obtain a Bachelor's degree from Wichita State, which major are you interested in?*

High School Graduation Year*

Most Recent or Current College Attended*

College CEEB Code - hidden

College Level-HIDDEN

Admit Type -HIDDEN

Student Type -Hidden

WSU Tech Accelerate - HIDDEN

Yes

No