Sponsored by:


The University of Tulsa

The National Science Foundation


2012 TTEC Student Application Form

This form may be submitted electronically, or printed and mailed to:

Tulsa TEC Academy
University of Tulsa
Education Department
800 S Tucker Drive
Tulsa, Ok 74104

* - required fields

Applicant's Email: *
(You must enter your e-mail address or the form will not be sent.)

Applicant's Personal Information

Applicant Name:

Last *

First *


Grade entering in the fall, 2012   4th     5th   6th   7th   

Parent/Legal Guardian Name:




Social Security Number

Address *

Phone *

Which academy do you prefer to attend?

Academy 1 
Enrollment closed

Academy 2
Enrollment closed

Academy 3
Academy 4
Academy 5
Academy 6

Education Information

Current school



Affirmative Action Information

The Tulsa TEC Academy as an education program sponsored by State and Federal funds and has a commitment to insure equity based on gender, race, ethnicity, or handicap. This information is confidential and will be used for statistical purposes only. Please place an check the appropriate area. Select one box only. If two or more ethnic categories are applicable, choose the one category with which you most closely identify.

Racial or Ethnic Category

American Indian or Alaskan Native

Asian or Pacific Islander

Black (not of Hispanic Origin)

White (not of Hispanic Origin)




Gender / Disability

Gender Male Female

Disability Yes No

                                What size T-shirt would you prefer?

YOUTH sizes

Small Medium Large X Large  

 ADULT Sizes

small medium large X Large X X Large


Please write one paragraph telling us why you are interested in this academy. 

Also tell us what technologies you currently use (Internet, word processing, digital cameras, etc...).

Please download and submit a letter of recommendation from a teacher to the above mailing address.


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Submission may take a few moments. Only click Send Message one time.

Problems or questions regarding this form should be directed to david-brown@utulsa.edu