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UA Graduate College Distance Campus Request for Information
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Thank you for your interest! You'll also find helpful information on our
Future Students
website. Your contact information will be shared with the graduate coordinator in the UA graduate program(s) you choose from the programs of interest list below.
Personal Information
*Required
First (Given) Name*
Last (Family) Name*
Email*
Phone Number
Please include area code
You may send text messages to me at this number. (Standard texting rates may apply)
You may send text messages to me at this number. (Standard texting rates may apply)
Yes
Birthdate (Optional)
Birthdate (Optional)
January
February
March
April
May
June
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August
September
October
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December
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1911
1910
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1908
1907
1906
1905
1904
1903
1902
1901
1900
Primary Citizenship
United States
Afghanistan
Aland Islands
Albania
Algeria
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Ashmore and Cartier Islands
Australia
Austria
Azerbaijan
Bahamas, The
Bahrain
Bangladesh
Barbados
Bassas Da India
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius, and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Clipperton Island
Cocos Islands (Keeling Islands)
Colombia
Comoros
Congo (Brazzaville)
Congo (Kinshasa)
Cook Islands
Coral Sea Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Europa Island
Falkland Islands (Islas Malvinas)
Faroe Islands
Federated States of Micronesia
Fiji
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia, The
Gaza Strip
Georgia
Germany
Ghana
Gibraltar
Glorioso Islands
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong S.A.R.
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Jan Mayen
Japan
Jersey
Jordan
Juan De Nova Island
Kazakhstan
Kenya
Kiribati
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Korea, South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau S.A.R.
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Man, Isle of
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Norway
Oman
Pakistan
Palau, the Pacific Islands of
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Spratly Islands
Sri Lanka
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tromelin Island
Tunisia
Turkey
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Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
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Vanuatu
Vatican City
Venezuela
Vietnam
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zambia
Zimbabwe
Are you Hispanic or Latino?
Are you Hispanic or Latino?
No
Yes
Ethnicity
Ethnicity
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific
White
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.
Are you a U.S. Permanent Resident?
Are you a U.S. Permanent Resident?
Yes
No
Educational Profile / Interests
Which distance campus are you interested in attending?
Which distance campus are you interested in attending?
Chandler
Douglas
Flowing Wells
Gilbert
Nogales
Phoenix
Pima - Desert Vista
Sierra Vista
Yuma
Use "Ctrl + click" to select multiple options.
Chandler
Aging Law and Policy (Certificate NDP)
Business Administration (MBA) - Online
Business Administration (MBA) - Professional MBA
Business Analytics (MS)
Business Foundations (Certificate NDP)
General Management and Organizations (Certificate NDP)
Health Information Privacy, Compliance, and Data Security (Certificate NDP)
Health Law for Health Professionals (Certificate NDP)
Healthcare Management (Certificate NDP)
Legal Paraprofessional (Certificate NDP)
Master of Legal Studies (MLS)
Regulatory Science (Certificate NDP)
School Psychology (EDS)
Teaching & Teacher Education (MED) - Teach Arizona
Teaching and Learning (MA)
Topics in Entrepreneurship (Certificate NDP)
Topics of Marketing (Certificate NDP)
Douglas
Teaching & Teacher Education (MED) - Teach Arizona
Flowing Wells
Teaching & Teacher Education (MED) - Teach Arizona
Gilbert
Nursing (MS) - Entry to the Profession
Nogales
Teaching & Teacher Education (MED) - Teach Arizona
Phoenix
Aging Law and Policy (Certificate NDP)
Bioethics (Certificate NDP)
Biomedical Engineering (MS)
Business Administration (MBA) - Evening MBA
Business Administration (MBA) - Executive MBA
Business Foundations (Certificate NDP)
Cardiovascular Translational Science (Certificate NDP)
Clinical Research (MS)
Clinical Translational Sciences (MS)
Clinical Translational Sciences (PHD)
Health Administration (Certificate NDP)
Health Information Privacy, Compliance, and Data Security (Certificate NDP)
Health Law for Health Professionals (Certificate NDP)
Master of Medical Studies (MMS)
Pharmacy (PharmD)
Public Health (MPH) - Health Services Administration
Public Health (MPH) - MEDMD-PHLMPH
Public Health (MPH) - Public Health Practice
Regulatory Science (Certificate NDP)
Pima - Desert Vista
Secondary Education (MED)
Secondary Education (MED) - Alternative Certification
Sierra Vista
Secondary Education (MED)
Secondary Education (MED) - Alternative Certification
Yuma
Agricultural Education (MS)
Agricultural Education (MS) - Professional Agriculture
Biosystems Engineering (MS)
Engineering Management (MS)
School Psychology (EDS)
Software Engineering (MS)
Systems Engineering (MS)
Teaching & Teacher Education (MED) - Teach Arizona
Teaching and Learning (MA)
Which semester and year do you intend to enroll at UA?
Fall 2024
Spring 2025
Summer 2025
Fall 2025
Spring 2026
Summer 2026
Fall 2026
Spring 2027
Summer 2027
Fall 2027
Spring 2028
Summer 2028
Fall 2028
Spring 2029
Summer 2029
Fall 2029
Spring 2030
Summer 2030
Fall 2030
Spring 2031
Summer 2031
Fall 2031
Spring 2032
Summer 2032
Fall 2032
Fall 2033
If there's any information you'd like to add, please enter it here. This is also a great place to tell us more about what you'd like to study if you aren't sure about which program to choose from the lists above.
Additional notes
By submitting this form, you consent to allow your data to be used in accordance with
UA Information Security & Privacy
. Use of personal data is governed by
UA Electronic Privacy Policy
.
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