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 PERSONAL INFORMATION

 

Last                                 First                                Middle
 

Maiden

Preferred

 Street Address 

City  State  Zip/Postal Code
 

County   Country

 

E-Mail Address

 

Home Telephone (include area code)

 

Work Telephone (include area code)

 

Cell Telephone (include area code)


Date of Birth mm/dd/yyyy
         Male      Female

 

Social Security Number

 

 Are you a U.S. citizen         Yes    No

 

If no, describe your status
    

 

 EDUCATIONAL BACKGROUND

 

Date of high school graduation or
                date GED obtained

 

Indicate month/year you plan to enroll in college

 

Please list any high schools, college or other educational institutions you have attended

 

Name of School                   City & State                     Dates of Attendance
      

      

      

 

 Additional schools, colleges and educational institutions attended:

 

What is your intended major? (If undecided please indicate such)

 

How did you first learn about McKendree University?

 

To which other colleges do you plan to apply for admission?

 

 

List courses you are taking or plan to take in this academic year:

 

Have you attended McKendree University in the past?

     If yes, provide the last date attended mm/dd/yyyy:

 

 

In what activities have you been particularly active during the past two years?

 

 In your own words, please share with us your interest in McKendree University.  What is it about McKendree that you find particularly appealing?

 

Is there any additional information you wish to share with the Admissions Committee relative to your academics performance or personal circumstances? If so, please provide it here.

 

  

 ADDITIONAL INFORMATION

 

Do you plan to file the Free Application for Federal Student Aid (FAFSA)?

       Yes    No

  

Are you a veteran?  Yes    No

 

Which location do you plan to attend?

 

 

 OPTIONAL INFORMATION

 

The following on race/ethnicity and religion may be completed if you wish.

 

African American/Black American Indian/Alaskan Native Asian American
Asian/Indian subcontinent Hispanic/Latin Multiracial
White/Caucasian Other

 

Religious background/denomination:

 

 

 APPLICANT'S AFFIDAVIT

 

I certify that the information I have given on this application is complete and correct to the best of my knowledge, and that I have attended no other institutions other than those listed.  I understand that it is my responsibility to have forwarded to McKendree University all official school records and other application materials and these documents become the property of McKendree University and shall not be returned to me or duplicated for any reason.  I also understand that my admission to McKendree University is subject to verification of all official records and that my admission may be rescinded should said records be materially different from other documentation on file.

 

 mm/dd/yyyy

 

Initials  

 

After you have completed the entire form, click the SUBMIT button. By electronically submitting this form, the applicant agrees to all of the provisions included in the Applicant's Affidavit section of this form.