Distance Learning Form

Please complete this data for us. All information is for UNIVERSITY USE ONLY and will remain confidential and secure. Note: This form will not update your information in the Registrar's office. Go to my.unt.edu to check and update your contact information at the Registrar's office.

Please complete this form for each distance education course that you are taking. Click and use the 'Return to the form' link or the 'Back' button on your browser to complete the form for the next course. If this information is not entered correctly, your instructor will not have a record of your submission.

Are you enrolled in any traditional 'On campus' classes at the UNT - Denton location this semester? (Enter YES if any of your classes primarily meet daily/weekly on campus. Enter NO if all of your other classes are primarily WEB or VTEL instructed, even if the classes have a meeting for the 1st class or for exams only.)
ex: 12345678
Course Information
ex: 5150
ex: 001
ex: Dr. Ann Smith
Current Address
ex: 123 Peach Street # 3A
ex: 76203 or 76203-1337
Preferred Mailing Address
(if different than the address above)
ex: 123 Peach Street # 3A
ex: 76203 or 76203-1337
Contact Information
Enter at least one so we have a way to contact you should the need arise.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
1 + 3 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.