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2014 UT Arlington AP* Summer Institute
Registration Form

To register for the 2014 UT Arlington AP* Summer Institute, you can fill out the form and submit it electronically or print this page after filling it out and mail it to the AP* Summer Institute at the address at the bottom of this page. It you do not want to enroll on-line, you may request a paper application. By enrolling on-line in an open course, you reserve your place in the class.

Items marked with a red asterisk ( * ) are required fields.

Registering on-line is performed as a secure transaction.

Please note: UT Arlington is a tobacco-free campus.

  Select your course

If you register for a full course, you will be placed on a wait list. If a space becomes available, participants on the wait list for that course will be contacted in the order of registration.

*Please enroll me in:

Week 1 - June 9 - 12, 2014:
Subject Areas: English, English, Foreign Language, Mathematics, Science, Social Studies

Week 2 - June 16 - 19, 2014:
Subject Areas: Art, Foreign Language, Mathematics, Science, Social Studies

Week 3 - June 23 - 26, 2014:
Subject Areas: English, English, English, English, Foreign Language, Mathematics, Science, Social Studies

  Personal and School Information

A registration receipt will be emailed to you after you complete this form. Please list an email address that you will check regularly. You should receive the email immediately but if you do not received it within a few days, please contact the UT Arlington AP* Summer Institute at 817-272-7215 or e-mail apsi@uta.edu.

*First Name:
Middle Name:
*Last Name:
*Home Address:
*Home city:
*Home state:
*Home zip:
*Home phone:
*Contact email:
*Re-enter your Contact email:

We will send automated emails to your email address, such as the registration receipt, course-related information when you are enrolled and important notices prior to the institute. Please give only one address.

Alternate email:

Please list only one address.

Additional Registration Receipt Emails:

If you would like to have your registration receipt sent to an additional email address, please enter that email address here. To send to more than one address, separate them with a semi-colon { ; }. Failure to use a semi-colon may result in no additional emails being sent. Addresses entered in this field will not be saved.

Special needs of participant:
(accessibility, dietary, et c.)
Emergency Contact:
Emergency Contact Phone number:
 
My school is outside the U.S.

Choose your school district from the list below. If your Texas school district is not listed, choose Not listed and you will be able to enter your district information. If your school does not have district administration or your school is not in the state of Texas, choose Not listed and reenter the name of the school.

*School District:
*School List:

*School Phone:
*How many years have you taught AP* courses:
*How many years have you taught Pre-AP* courses:
*What grade range do you currently teach:
  Parking options

Parking on campus is free but you must display a hangtag identifying you as an AP* Summer Institute participant. We can issue only one hangtag per participant. Please choose one of the following options:

 I do not require a permit.  Automobile  Motorcycle  Disabled

  Cost
APSI Early Registration Tuition:
(Before May 15, 2014) (includes lunch Monday through Thursday)
$450
Total Amount Payable to UT Arlington APSI:
(Payable in U.S. Dollars)
$450
  Payment

Payment by Personal or Institutional Check are not available with online registration.
To pay by Check, you can download our registration form or fill out this web form and click Mail-in Registration at the bottom.
To pay by Institutional Check, you can additionally choose to pay by Purchase Order.

 Purchase order
 Visa
 MasterCard
 American Express
 Discover
  Final Information

Click the Submit Online Registration button to send your registration information. You will then be presented with a page that has your registration receipt which you should print out and keep for your records. A copy of this information will be immediately emailed to the address(es) you provided. You will will not be enrolled in your chosen course until we have received your registration payment.

Click the Mail-in Registration button to display your registration information in a printer-friendly format. Mail or fax your registration form along with payment information to our office. You will not be registered until a completed form and payment have been received.

Please note: UT Arlington is a tobacco-free campus.


You may be entitled to know what information UT Arlington (UTA) collects concerning you. You may review and have UTA correct this information according to procedures set forth in UT System Policy #139. The law is found in sections 552.021, 552.023 and 559.004 of the Texas Government Code. For more information, UTA's Privacy Policy is available on-line at http://www.uta.edu/oit/policy/Internet-privacy.php.

  Contact Information

Address any questions concerning APSI to:

AP* Summer Institute
Box 19322
Arlington, Texas 76019-0322

phone: (817) 272-7215
fax: (817) 272-5248

email: apsi@uta.edu

© 2014 AP Summer Institute @ UT Arlington
College Hall, Suite 108 • 600 South West St • Arlington, TX 76019
e: apsi@uta.edu  •  p: 817-272-7215  •  f: 817-272-7217
Trademark Notice: College Board, AP, Pre-AP, Advanced Placement Program, AP Vertical Teams and the acorn logo
are registered trademarks of the College Entrance Examination Board. Used with permission.