Academic HealthPlans
Student Login
Welcome to Tarleton State University - Intl
Tarleton State University
Student Registration Form
International Students Only
Waiver Account Creation
This form will create your waiver system account which can be used again in subsequent semesters. Completing this form will NOT submit a waiver request.
Student information
First Name
*
Student ID
*
Middle Name
Birth Date (MM DD YYYY)
*
Last Name
*
Gender
*
-- Select --
Male
Female
X - Non-Binary
Address
Address
City
State
-- Select --
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AS
DC
FM
GU
MH
MP
PW
PR
VI
Zip
Contact Information
School Email
*
Personal Email
Parent/Alternate Email
Student Phone
*
Your waiver submission has NOT been completed
Select the 'REGISTER' button below to go to the Student Dashboard. Next select the red waiver button under the "NO, I do not want the insurance." section. Then you will be able to enter your waiver information and submit your waiver request.
Set Your Password
Password
*
Confirm Password
Sign up for Waiver Status messages. You will receive a text message whenever there is a status change on your waiver submission(s).
Signup for Texts:
Mobile Number
*
:
Tarleton State University