Carroll University
Admissions > Part-time Students > Apply to Carroll > Application for Admission
 
 
 

Part-time Student Application for Admission

Complete this form to apply to Carroll University as a part-time student.

An asterisk(*) denotes a required field.

Carroll University Part-time Student Application

Personal Information

*Last Name:
*First Name:
Middle Name:
Preferred First Name:
Former Last Name(s) if any:
Gender: Male Female
Date of Birth:
*Email Address:

Home Address

*Street:
*City:
*State:
*Zip Code:
County:
Home Phone:
Cell Phone:
Employer:
Business Phone:

Business Address

Street:
City:
State:
Zip Code:
Marital status (optional): Single  Married Divorced
If you are not a U.S. citizen, what kind of Visa are you on? Visa:  
If you are not a U.S. citizen, what country is your citizenship from? Country:  

Ethnicity Information

Are you Hispanic or Latino? Yes No
Select one or more of the following: American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

Enrollment Information

Plan to Attend: Part-time (11 credits or less)  Full-time (12 or more credits)
Intended Major:
Have you previously applied to or Attended Carroll University? No  Yes, Dates:
Name Used, if different:
Planned Enrollment Session:
Planned enrollment year:
I will be:
Are you seeking pre-requisites for a graduate program at Carroll? Yes  No

If yes, what graduate program?

Educational Information

Please list all of the high schools you have Attended.
High School #1 Name:
High School City, State, Zip:
Dates Attended: From: To:
Date of Graduation:
High School #2 Name:
High School City, State, Zip:
Dates Attended: From: To:
Date of Graduation:
High School #3 Name:
High School City, State, Zip:
Dates Attended: From: To:
Date of graduation:
Please list ALL of the colleges/technical schools you have Attended. You must declare schools Attended, even if no credit was Earned.
College #1 Name:
College City, State, Zip:
Dates Attended: From: To:
Degree Earned:
College #2 Name:
College City, State, Zip:
Dates Attended: From: To:
Degree Earned:
College #3 Name:
College City, State, Zip:
Dates Attended: From: To:
Degree Earned:
**Applicants seeking a degree or educational certification are required to submit official transcripts from all post-secondary institutions Attended. High school transcripts are required of degree seeking students.

Financial Arrangements

Do you plan to apply for financial aid by filing the FAFSA? No  Yes
Are you eligible for Veteran's Education benefits? No  Yes

All Applicants Must Complete This Section

Have you ever been dismissed from school for disciplinary reasons? No  Yes
Have you ever been convicted of any offense other than a minor traffic violation? No Yes, please explain

Register for classes


Part-time Registration Form

(pdf download)

Carroll University is committed to maintaining a safe learning environment for all members of the college community. As such, the college requires all applicants who are under current indictment, who have been convicted of a crime (other than a routine traffic offense or a juvenile proceeding), or who have been dismissed from another academic institution for disciplinary reasons, to disclose this information as a mandatory step in the application process. A previous conviction, current indictment or disciplinary dismissal does not automatically bar one’s admission to the college.

I understand that withholding pertinent information on this application, or giving false information, will: (a) make me ineligible for admission to Carroll University; (b) cancel my registration if admission has occurred; and/or (c) subject me to dismissal from the college if I have already enrolled.

Carroll University does not discriminate on the basis of race, sex, creed or religion, age, color, national or ethnic origin, or disability in the administration of its educational policies, admission policies, or scholarship and loan programs.

 
 
 
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