Texas Tech University :: College of Outreach & Distance Education
Request an Extension
STUDENT INFORMATION
You may extend your course one time only, for six months. An extension can only be granted one time per course and may not be split between two or more courses. You must extend and make payment before your expiration date. No refund is granted for extensions.

First Name:
Last Name:
Birthdate: (mm/dd/yy)
Social Security # or matriculation #:
If you did not provide a valid Social Security # on your enrollment form, you were assigned a matriculation number.
Address:
City:
State:
Zip:
E-mail:
By providing your e-mail address, you are authorizing CODE to send you relevant information and/or updates electronically. For more information about TTU's Privacy Policy, visit www.ttu.edu/policy/privacy.php.

This is a new address.
I am a TTUISD student.

Phone:
ext:
Course:
K-12 extensions are $50 per course. College and dual-credit extensions are $100 per course. To extend more than one course, you will need to complete one extension request form per course.

Please charge my extension fee to:
MasterCard
Visa
Discover
American Express
Card Number:

Expiration Date:

Cardholder Name:

Security Code:
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I agree to abide by all of the policies and procedures governing Texas Tech University's College of Outreach & Distance Education.