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| Personal Information |
*Last name: |
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*First name: |
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Middle name: |
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Preferred first name: |
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Former last name(s) if any: |
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Gender: |
Male
Female |
Date of Birth: |
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*E-mail address: |
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Home address: |
*Street: |
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*City: |
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*State: |
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*ZIP: |
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County: |
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Home Phone: |
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Cell Phone: |
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Employer: |
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Business phone: |
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Business address |
Street: |
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City: |
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State: |
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ZIP: |
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Marital status (optional): |
Single
Married
Divorced |
If you are not a U.S. citizen, what kind of Visa are you on? |
Visa:
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If you are not a U.S. citizen, what country is your citizenship from? |
Country:
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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: |
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Have you previously applied to or attended Carroll University? |
Yes
No, Dates:
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Name used, if different: |
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Planned enrollment session: |
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Planned enrollment year: |
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I will be: |
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Are you seeking pre-requisites for a graduate program at Carroll? |
Yes
No
If yes, what graduate program?
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Educational Information |
Please list all of the high schools you have attended: |
High School name: |
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High School City, State, ZIP: |
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Dates attended: |
From:
To:
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Date of graduation: |
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High School name: |
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High School City, State, ZIP: |
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Dates attended: |
From:
To:
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Date of graduation: |
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High School name: |
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High School City, State, ZIP: |
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Dates attended: |
From:
To:
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Date of graduation: |
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Please list ALL of the colleges/technical schools you have attended. You must declare schools attended, even if no credit was earned. |
College name: |
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College City, State, ZIP: |
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Dates attended: |
From:
To:
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Degree earned: |
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College name: |
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College City, State, ZIP: |
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Dates attended: |
From:
To:
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Degree earned: |
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College name: |
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College City, State, ZIP: |
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Dates attended: |
From:
To:
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Degree earned: |
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**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? |
Yes
No |
Are you eligible for Veteran's Education benefits? |
Yes
No |
All Applicants Must Complete This Section |
Have you ever been dismissed from school for disciplinary reasons?
Yes
No |
Have you ever been convicted of any offense other than a minor traffic violation?
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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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*indicates a required field |
