Request for Information

Your Academic Plans

What type of student are you? (Required)

Which campus location would you like to attend? (Required)

What do you plan to study? (Required)

You selected an online degree-completion program available only to registered professionals working in this field.

If you are not a registered professional already working in this field, please select a different campus and/or program. View all online programs here.

When would you like to enroll in classes? (Required)

Search for your high school (Required)

When will you graduate high school?(Required)

Most recent college attended? (Required)

When did you stop attending? (Required)

About You

First Name (Required)

Preferred First Name

Last Name (Required)

Birthdate (Required)

Contact Information

Preferred Email Address (Required)

Use only a standard email provider for your preferred email address such as gmail or yahoo.

Email addresses assigned by your school or work might block messages sent from Oregon Tech.

Cell Phone Number

By providing your cell phone number you consent to receiving text messages from Oregon Tech.

Home Phone Number

Mailing Address (Required)

Country

Street

City

Region

Postal Code

Do you physically live at the above address? (Required)

Home Address

Country

Street

City

Region

Postal Code

Would you like to receive a viewbook?

No

Yes

Parent / Guardian Information (Required if under 18)

Parent/Legal Guardian First Name

Parent/Legal Guardian Last Name

Parent/Legal Guardian Phone

Parent/Legal Guardian Email

Parent/Legal Guardian Address

Country

Street

City

Region

Postal Code

Relationship

Are you the Parent/Legal Guardian filling out this form? It's ok, be honest :)

No

Yes

Select "Yes" if you would like to enter optional information.

No

Yes

Optional Information

T-Shirt Size

Are you Hispanic or Latino?

Yes

No

Select the most appropriate answer regarding your United States Armed Forces affiliation.