PREP @ UAZ Request for Information

Complete the form below to request information from PREP @ UAZ. Your contact information will be shared with the graduate coordinator for this program.

First (Given) Name*

Last (Family) Name*

Email*

Phone Number

You may send text messages to me at this number. (Standard texting rates may apply)

Yes

Have you received or will you receive your bachelor's degree within 36 months of starting in PREP @ UAZ?*

Yes

Are you affiliated with an American Indian/ Alaskan Native tribe?

Yes

Under federal reporting guidelines, you may choose not to respond to this question. Choosing to respond or not to respond will not prejudice your application in any way.

Additional notes