Dorm Reservation

First Name

Field is required!

Last Name

Field is required!

E-mail Address

Field is required!

Phone Number

Field is required!

Address

Field is required!

Zip Code

Field is required!

City

Field is required!

Current Degree

Field is required!

Semester / Year

Field is required!

Desired Degree Program

Field is required!

Gender

Male

Female

Field is required!

Do you require any special accommodations due to physical disabilities?

Yes

Field is required!

If you answered “Yes”, have you registered with the Office Of Disability Services In Knoxville?:

Yes

Field is required!

Room Preference

Single Occupancy at $400.00 per month.

Double Occupancy at $225.00 per month

Field is required!

A security deposit of $400.00 is required when making a reservation. The security deposit payment can be made by check, money order or credit card (VISA, MasterCard, Discover). For Credit Card payment please contact us at admit@utsi.edu.

Submit

For Check or Money Order, please remit to:
Admissions Office, MS06
The University of Tennessee Space Institute
411 B. H. Goethert Parkway
Tullahoma TN, 37388‐9700