First name of the registrant.
Last name of the registrant.
Enter your work email address.
Enter your work phone number.
Select name from the list of Texas STATE entities. Navigate list quickly by keying first letter of name.
If not found, choose the last option (ZZ-Other) and enter the name in the Dept/Div field.
Use Notes box for comments or to advise of a special request.
For special accomodation needs or other assistance, please notify DIR at least one week in advance to allow time for an apporpriate solution.