Student Application for Faculty-Led Program

*Requirements:

-be a full-time enrolled student at TTU
-must be registered for the related course
-must have approval from the faculty leaders and meet the requirements established by him/her
-Review all orientation materials and complete assessment

1General Information > 2Uploads and Releases
Tennessee Technological University, a public institution of higher education created by the laws of the State of Tennessee, is located at 1 William L. Jones Drive, Cookeville, TN 38505 (931-372-3101). Tennessee Tech collects the information you provide to it through its website’s portals, request for information forms, etc. for the purpose fulfilling its mission as required by Tennessee Code Annotated Section 49-8-101(d). Tennessee Tech may share the information you provide with contractors and state or federal authorities if required by law or if necessary to fulfill its stated mission.

Tennessee Tech will store your personal data consistent with its policy on document retention, which can be accessed through the Policy Central portal on this website. If you are a resident of the European Economic Area (“EEA”) and have standing under the General Data Protection Regulation 2016/679 of the European Parliament and of the Council of 27 April 2016, you have the right (i) to request from Tennessee Tech access to and rectification or erasure of personal data or restriction of processing; (ii) to object to processing; (iii) to data portability and (iv) to lodge a complaint with a supervisory authority in the EEA.

By providing personal data to Tennessee Tech, you consent to the processing of your data for the purposes described above.
Name Name First Middle Last
Faculty Leader(s)
Faculty Leader Email
Location of Program
Term in which you are registered for the course.
T number
Must be 9 characters. Currently Entered: 0 characters.
TTU Email
Date of Birth Date of Birth / MM / DD YYYY
Gender
Race
Citizenship
Passport number (if you have it)
Passport copy (if you have a passport already)

Attach Files

Please, send us a scanned copy of the main page of the passport as soon as you get it to: almiller@tntech.edu
Application for passport in progress

Application for passport in progress

Please email a copy of your passport to the Study Abroad Office as soon as it arrives.
Permanent Home Address Permanent Home Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Local Address Local Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cell Phone Cell Phone - ### - ### ####
Classification
Major/Minor/Concentration
Expected Graduation Date Expected Graduation Date / MM / DD YYYY
Legal Emergency Contact 1 Legal Emergency Contact 1 First Last
Please only put contacts who would be legally responsible to make medical decisions for you.
Relationship
Email
Phone Phone - ### - ### ####
Legal Emergency Contact 2 Legal Emergency Contact 2 First Last
Please only put contacts who would be legally responsible to make medical decisions for you.
Relationship
Email
Phone Phone - ### - ### ####
Medical History-please disclose all medical information and keep updated
Have you had any serious illnesses, conditions or injuries in the past 5 years?
If yes, describe:
Are you currently taking any medications (prescription or non-prescription)?
If yes, please list:
Do you have any disabilities?
If so, please explain:
Allergies: please list any allergies you have (meds, food, etc.)
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.

Student Application for Faculty-Led Program

Student Application for Faculty-Led Program

Medical History-please disclose all medical information and keep updated