Dorm Reservation

First Name
Field is required!
Field is required!
Last Name
Field is required!
Field is required!
E-mail Address
Field is required!
Field is required!
Phone Number
Field is required!
Field is required!
Address
Field is required!
Field is required!
Zip Code
Field is required!
Field is required!
City
Field is required!
Field is required!
Current Degree
Field is required!
Field is required!
Semester / Year
Field is required!
Field is required!
Desired Degree Program
Field is required!
Field is required!
Gender
Field is required!
Field is required!
Do you require any special accommodations due to physical disabilities?
Field is required!
Field is required!
If you answered “Yes”, have you registered with the Office Of Disability Services In Knoxville?:
Field is required!
Field is required!
Room Preference
Field is required!
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.

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