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Biology in National Parks Application

Date of Birth
Classification *

Health Information

Students under the age of 18 must fill out the attached PDF and obtain a parent/guardian's signature. 

The purpose of this health information questionnaire is to help Texas State be of maximum assistance during your extension studies experience. Mild physical or psychological disorders can become exacerbated with the stresses of life while studying elsewhere. It is important that the program be made aware of any medical or emotional problems you have experienced. The information provided will remain confidential and will be shared with program staff, faculty, or appropriate professionals only if necessary to your well-being. Texas State may not be able to accommodate all individual needs or circumstances. This information does not affect your admission to the program. 

Please answer Yes or No to the following questions.

Health Insurance Coverage *

Activity Release of Liability, Indemnification and Assumption of Risk Agreement

This is a release of Liability, Indemnification and Assumption of Risk agreement. Read it carefully and sign below. Completion of this form is required before you participate in any Study-in-America program. This form cannot be altered or modified by any verbal or written statements. 

Please initial in the spaces provided. 

Holds

If you have a hold on your account, it will prevent you from being able to register.

You can check for holds via CatsWeb.

Probation

We recommend you contact your advising center to ensure courses satisfy your educational goals.

Suspension

Suspension from any college or university may prevent you from being able to register.

Are you presently on suspension from any college or university? *

Financial Aid and Scholarships

Federal financial aid and Pell Grant programs require that students be enrolled in programs leading to a degree or some other educational credential to be eligible for financial aid. Students enrolled solely in extension studies courses may not be eligible; please contact the Texas State Office of Financial Aid and Scholarships for more information. Extension courses are considered part of your course load for the purpose of determining eligibility for the amount of federal financial aid received by Texas State students. If you have questions regarding financial aid and scholarships, contact the Texas State Office of Financial Aid and Scholarships at 512.245.2315.

Tuition Assistance: Third-Party Billing

Any Tuition Assistance applied to your University account will NOT be automatically applied to your Extension course tuition.

If you have forwarded Tuition Assistance documentation to Texas State University - Student Business Services or have Tuition Assistance documentation covering all or part of your Extension course tuition, you MUST also forward this documentation to our office so that your Tuition Assistance can be applied to your Extension course charges and in accordance with the University's policies.  It is in your own best interest to declare Tuition Assistance when applying for your course as any remaining balances may cause your registration to be dropped, and may incur further charges, etc.  For additional information please contact the Office of Distance & Extended Learning.

Extension Credit Course Policies

Please download and read the Extension Credit Course Policies.

When you have finished reading the document, please check the box below.  *

Family Educational Rights and Privacy Act (FERPA)

FERPA protects the privacy of the student education records and guarantees students' access to their own records.  In order for the Office of Distance and Extended Learning to release or discuss a student's academic record with a specified third party a Grant Access Student's Record Form must be on file with the University.  Go to www.registrar.txstate.edu/legislative-policies/ferpa.html to print the form.  Complete the form and upload.

Academic Honesty *

Disability Statement

If you have a disability and require special accommodations taking the course/s and/or exam/s, contact the Office of Disability Services, Room 5-5.1 LBJ Student Center, or 512.245.3451 (Voice TTY).

Additional Information

Signature and Certification Statement 

By entering my name in the field above and by checking the box below, I certify that *