University of North Texas

Student Registration Form

IELI Students Only

Student information

First Name*

Middle Name

Last Name*

Birth Date (MM DD YYYY)*

8-digit UNT Student ID *

Gender*

Address

City

State

Zip

Contact Information

Student Email*

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 waiver button under the "I Already Have 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 * :