Chem Winter Bootcamp Priority Request Form

Email Address

First Name

Preferred First Name

Middle Name

Last Name

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Mobile Number

I confirm that I am submitting only one application. Any additional submissions using alternate email addresses, names, or contact information will be considered duplicates, will be canceled, and may result in my ineligibility to enroll in the course.

Yes

Confirm Session Term

Winter 2027

Winter 2028

Winter 2029

Which University would you like to attend?

UW-Green Bay

UW-Green Bay at Manitowoc campus

UW-Platteville

UW-Whitewater

By signing, I confirm the following:

I will email chemboot@uww.edu if I no longer need to reserve my spot as soon as I know.
I understand that I may select only one campus during registration. Any additional submissions using alternate email addresses, names, or contact information will be considered duplicates, will be canceled, and may result in my ineligibility to enroll in the course.
I understand this registration does not guarantee acceptance or enrollment in the course. Completing this application on secures a place for me on the priority list.
I understand the campus I selected will contact me with instructions on how to complete the enrollment process if space is available.
I also understand that I will enroll in the course by provided deadline or my spot will be opened up to the next person on the waitlist.

Click to Sign...