Intent/Interest Form

First Name *

Last Name *

Date of Birth *

Gender Assigned at Birth *

Contact Information

Email *

Phone *

Address *

Country

Street

City

Region

Postal Code

Race/Ethnicity

Are you Hispanic or Latino? *

Yes

No

Regardless of your answer to the prior question, please select all you identify with: *

Questions/Comments

Submission & Sharing of Education Records *

As a current student at the University of Wisconsin-Milwaukee at Waukesha I understand that this form submission could be used to create an application to Waukesha County Technical College (WCTC).

By electronically submitting this form, I am indicating my interest in admission to Waukesha County Technical College (WCTC) in lieu of submitting a formal admission application. I understand that after submitting this form, WCTC and the University of Wisconsin-Milwaukee at Waukesha will share personally identifiable information/records about me between institutions to facilitate my admissions to WCTC, including any financial aid, consistent with 34 CFR 99.31 (a) (2) and 99.34 (a) (1) (regulations implementing the federal Family Educational Rights and Privacy Act (FERPA)).