PLTL Request Form
Please fill in this form
completely
and click submit.
Last Name (without spaces)
First Name
Student ID
Year
Select year
Freshman
Sophomore
Junior
Senior
Major
Select major
AFST
ART
BIO
CHE
CECE
CDIS
COM
ECO
ENG
FSA
GRY
GLY
HEA
HIS
IST
KIN
MAT
MDL
PERF
PHI
PED
PHY
POL
POL
PSY
REC
SOC
SPM
SHH
Other
EXS
CHEA
SOC
PRE
HSC
BMS
BCH
Phone number(10 digits including area code)
Email you check (please type carefully)
Course you are taking
GenChem1
GenChem2