MTSA: Request for Guest Attendance Form

The informal guest may be allowed to visit pre-determined lectures within a class at MTSA. without tuition, fees, examinations, grading or credit, and no record is maintained.  Any individual desiring to attend a lecture as a guest must have a prior student relationship with the school.  Guest attendance during a lecture is at the discretion of the course instructor.  The individual will not have access to tests, test material, or library services.  Clinical Practicum, Simulation Lab, Research and Independent Study courses will not accommodate guest attendance.  Attending lectures does not improve the individual's standing for admission.  All guests must abide by MTSA policies while on campus.  (Policies/handbook available online at

(Please Print) All information is required

Student first name:                                      Middle:                      Last:                                     

Street Address:                                                                                                                              

City:                                                               State:                                      Zip:                           

Cell Phone Number: (     )                           Home Phone Number: (      )                                  

E-Mail Address:                                                                                                                              

  • Are you currently enrolled at MTSA?                       YES                    NO              
  • Have you previously attended MTSA?                     YES                    NO              
  • What course do you wish to attend as a guest?

            Course Number:                                                                                          

            Course Title:                                                                                                 

            Course Instructor:                                                                                       


Student Signature:                                                                                                                          

Instructor Signature:                                                                                                                       

Instructor Printed Name:                                                                                                                

Vice President of Academics Signature:                                                                                      

Vice President of Academics Printed Name:                                                                               


OFFICE USE ONLY: Copy of guest driver license obtained     YES                      NO