Student College Application

STUDENT COLLEGE APPLICATION

Application Type & Program

Application for: First-time undergraduate Transfer Readmit Graduate/Professional

Applicant Information

Full legal name:

Former / other names used (if any):

Date of birth: Gender: Student ID (if known):

Primary phone: Email address:

Citizenship & Residency

Country of citizenship: If not a citizen, indicate immigration status:

State of legal residence for tuition purposes: Length of continuous residence in that state (years):

I certify that the information regarding my residency status is true and authorize the institution to verify residency as necessary:

Academic History

Graduation date: GPA (cumulative):

Standardized Test Scores (if applicable)

SAT (CR+M): Date taken:

ACT composite: Date taken:

Disclosures & Certifications

Have you ever been dismissed, suspended, placed on probation, or subject to disciplinary action by any educational institution? Yes No

Have you ever been convicted of a felony or misdemeanor (excluding minor traffic offenses)? Yes No

If yes to either question above, provide a brief explanation (dates, institution, disposition):

Emergency Contact & Medical

Financial & Payment

Will you apply for financial aid? Yes No

Authorizations, Releases, and Agreements

By submitting this application I certify that the information provided in this application and any supporting documents is true, correct, and complete to the best of my knowledge. I understand that falsification, omission, or misrepresentation of information may result in denial of admission, rescission of an offer, or disciplinary action under institutional policy.

I authorize the institution to obtain, review, and verify my academic records, test scores, and any information necessary to evaluate my application. I authorize prior educational institutions and testing agencies to release records and results to the institution upon request.

I acknowledge the institution's right to verify residency and financial information and to share information for official educational purposes, consistent with applicable privacy law. I understand that my application and supporting materials become the property of the institution and will not be returned.

FERPA release: By signing below I consent to the limited release of my education records and directory information to designated persons or agencies as specified in writing to the Office of Admissions. This consent may be revoked in writing at any time except to the extent action has already been taken.

I also grant the institution permission to contact me via telephone, text message, or email regarding my application and enrollment matters. I understand message and data rates may apply.

Applicant Certification

Applicant signature below certifies acceptance of the statements and authorizations contained in this application. The applicant affirms that all documentation provided in support of this application is accurate and complete. Applicant agrees to comply with institutional policies applicable upon admission.

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