Part-time Studies Application | Carroll University

First Name:

Preferred First Name:

Middle Initial:

Last Name:

Former Last Name(s) if any:

Email:

Home Address

Street Address:

City:

State:

ZIP code:

Country:

Home Phone:

( ) -

Mobile Phone:

( ) -

Business Address

Employer:

Address:

City:

State:

ZIP code:

Business Phone:

( ) -

Personal Information

Gender:

Female
Male

Marital status (optional):

Single
Married
Divorced

Are you Hispanic or Latino?:

Yes
No

Select one or more of the following:

Visa:

If you are not a U.S. citizen, what kind of Visa are you on?

Country:

If you are not a U.S. citizen, what country is your citizenship from?

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?:

Yes
No

If previously applied, when?:

Name used when previously applied (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

High School #1 Name:

City, State, Zip:

Dates Attended:

Date of Graduation:

High School #2 Name:

City, State, Zip:

Dates Attended:

Date of Graduation:

High School #3 Name:

City, State, Zip:

Dates Attended:

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:

City, State, Zip:

Dates Attended:

Degree Earned:

College #2 Name:

City, State, Zip:

Dates Attended:

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?:

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?:

Yes
No

Yes, please explain:

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.

Part-Time Studies Application for Admission

Home Address

Business Address

Personal Information

Enrollment Information

Educational Information

Financial Arrangements

All Applicants Must Complete This Section

Part-Time Studies
Application for Admission