University of Connecticut
School of Engineering
Pre-Engineering Program Application

Please fill in the following information:

Registration

  • Space is limited. Grades are capped at 30 students.

    Credit cards, money orders, or checks are accepted. Please make checks payable to UCONN and mail them to the Pre-Engineering Program address.
 

Student Information

 

School Information

 

Pre-Engineering Transportation/Emergency Waiver

    Transportation

  • Parent/Guardian

  • If you did not check the box above (and so your address is different from your child's address), please enter your address below:

  • Second Parent/Guardian

 

Medical Information

  • Health Insurance

  • Family Physician

 

Pre-Engineering Health/Emergency Waiver

  • I waive all liability of the University of Connecticut during the participation of my child
  • In the Pre-Engineering Program, I understand that the University will not be responsible for any costs related to emergency or any other hospital visits, accidents or illness. As parent or legal guardian of the above student, I agree to pay all health related costs that may arise during my son or daughter's participation in the Pre-Engineering Program.
 

Verification

If you are experiencing any technical difficulty with the online application, please download a hard copy here and mail to address list on application, email to engr-edpsw@uconn.edu, or fax to (860) 486 – 3045. After filling out the form, please submit your payment at: https://secure.touchnet.com/C21646_ustores/web/product_detail.jsp?PRODUCTID=59.