North Carolina A&T State University Undergraduate Admissions Application Instructions

Similar documents
EQUAL EMPLOYMENT OPPORTUNITY DATA FORM Please Return to: City of Geneva Human Resources 22 South First Street Geneva, IL 60134

AMERICAN AMBULANCE SERVICE, INC.

EMPLOYMENT APPLICATION

CITY OF HOLLY HILL EMPLOYMENT APPLICATION 1065 Ridgewood Avenue Holly Hill, Florida An Equal Opportunity Employer

Applicant Information

Admission Requirements

NASSAU COUNTY BOARD OF COUNTY COMMISSIONERS OFFICE OF HUMAN RESOURCES Nassau Place, Suite 5, Yulee, Florida 32097

Application for Admission

Last Name First Name M.I. Name You Prefer. City State Zip Address. Daytime Phone Evening Phone Best Time to Call. City State If yes, where?

Title: Date Available:

Employment Application

APPLICATION FOR EMPLOYMENT

VOCATIONAL NURSING APPLICATION PROCEDURES

WAKULLA COUNTY. EMPLOYMENT APPLICATION Equal Opportunity Employer/Affirmative Action Employer EDUCATION HIGH SCHOOL: POSITION APPLIED FOR.

HELENE FULD COLLEGE OF NURSING 24 East 120 th Street New York, NY Telephone Fax Website

HELENE FULD COLLEGE OF NURSING

Application for Graduate Admission

APPLICATION FOR ADMISSION

AMHERST COUNTY SHERIFF'S OFFICE An equal opportunity employer Women and Minorities are encouraged to apply.

Employment is contingent upon completing a six (6) month probationary period.

General Employment Application

Juvenile Services Officer Application Information

Columbia College Director of Teacher Education and Accreditation

Application Deadline for the Nursing Program is February 1, 2018 for Fall 2018 Admission. Turn in to Room 110-H between the hours of 8:30-4:00pm.

Thank you for your interest in employment with Black Hills Surgical Hospital and Black Hills Urgent Care.

If applying for Testing Accommodations under the Americans with Disabilities Act (ADA):

Additionally, the parent or legal guardian must provide the following documents upon registration of a new student:

GENERAL APPLICATION FOR EMPLOYMENT

MAINE STATE BOARD OF NURSING

Today s date: Social Security Number: Birth Date MM/DD/YY / / City State Zip Parish/County

APPLICATION FOR EMPLOYMENT EASTERN SHORE RURAL HEALTH SYSTEM, INC, Market Street, Onancock, VA 23417

MILLERS COLLEGE OF NURSING

APPLICATION FOR EMPLOYMENT

Bachelor of Science Nursing (RN to BSN)

Name: First Middle Initial Last Social Security Number: Current Street Address/Apt #: City: State: Zip Code:

Carlisle Police Department Employment Application

PLEASE TYPE OR PRINT CLEARLY USING A PEN. Today s Date:

Florida Financial Aid Application

(City) (State) (Zip Code) (Evening) Are you legally authorized to work in the United States? Yes. No If yes, who? EMPLOYMENT DESIRED

If applying for Testing Accommodations under the Americans with Disabilities Act (ADA):

2. Use the space bar or the mouse to check the appropriate boxes.

An Equal Opportunity Employer

APPLICATION FOR EMPLOYMENT

APPLICATION FOR WYOMING LICENSED REGISTERED NURSE with ADVANCE PRACTICE RECOGNITION *All licenses expire December 31 of every EVEN year*

Volunteer Application

International Academy of Mathematics & Science

APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) *All licenses expire December 31 of every EVEN year*

DOCTOR OF NURSING PRACTICE PROGRAM. Graduate Application and Admission Information

AVI Systems, Inc. Employment Application

DELTA STATE UNIVERSITY ROBERT E. SMITH SCHOOL OF NURSING RN TO BSN COMPLETION PROGRAM APPLICATION

GENERAL APPLICATION FOR EMPLOYMENT Human Resources City of New Smyrna Beach 210 Sams Avenue New Smyrna Beach, Florida 32168

CITY OF BRANDON POLICE DEPARTMENT APPLICATION FOR EMPLOYMENT. ALL applicants MUST attach items 1, 2, 3, 4 I. PERSONAL HISTORY

RANDOLPH COUNTY SHERIFF S OFFICE. Sheriff Eddie L. Fairbanks APPLICANT'S BOOKLET

North Carolina Extension Master Gardener Volunteer Application Guilford County

Licensed Nursing Assistant Renewal/Reinstatement Application

APPLICATION INFORMATION

FREE TRAINING CAREER SUPPORT SERVICES

APPLICATION FOR EMPLOYMENT

Candidates failing to include ALL required documentation will be disqualified.

PERSONAL INFORMATION Male Female

COPPIN STATE UNIVERSITY College of Health Professions Helene Fuld School of Nursing

APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) *All licenses expire December 31 of every EVEN year*

MAINE STATE BOARD OF NURSING

City of Pigeon Forge Police Department. Position: The City of Pigeon Forge Police Department is accepting applications for Communications Officer.

Application For Employment

EMPLOYMENT PRE-SCREEN QUESTIONNAIRE

ALAMEDA COUNTY EMPLOYMENT APPLICATION

APPLICATION FOR EMPLOYMENT

CODAC BEHAVIORAL HEALTH SERVICES, INC.

TRAVIS COUNTY EMERGENCY SERVICES DISTRICT #4 FIRE AND EMT ACADEMY CADET CLASS XV APPLICATION

GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL

EMPLOYMENT PRE-SCREEN QUESTIONNAIRE

Incomplete applications will not be considered.

APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) *All licenses expire December 31 of every EVEN year*

Education and Training

MAINE STATE BOARD OF NURSING

Optometry Renewal Application

APPLICATION FOR WYOMING LICENSED REGISTERED NURSE (RN) *All licenses expire December 31 of every EVEN year*

6965 Cumberland Gap Parkway Harrogate, TN nursing.lmunet.edu Family Nurse Practitioner Concentration

Crandall Fire Department

FIRE RECRUIT CIVIL SERVICE COMMISSION CITY OF TYLER, TEXAS MINIMUM QUALIFICATIONS

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing.

Optometry Renewal/Reinstatement Application

HELENE FULD COLLEGE OF NURSING 24 East 120 th Street New York, NY Telephone Fax Website

APPLICATION FOR EMPLOYMENT Wallace Community College Selma

The College of Science & Mathematics &CGCE Department of Nursing Application Admission

Adams County Court for Veterans Mentoring Program Information Sheet

State of Florida Department of Health. Board of Osteopathic Medicine. Application for Registration as an Osteopathic Physician in Training

VERMONT JUDICIAL BRANCH EMPLOYMENT APPLICATION

CITY OF PLANT CITY 302 W. REYNOLDS STREET P. O. BOX C PLANT CITY, FLORIDA PHONE (813)

APPLICATION FOR ADULT UNDERGRADUATE PROGRAM

Last Name First Name Middle Initial Today s Date. Desired Shift Day Shift Night Shift

APPLICATION FOR EMPLOYMENT

TEMPORARY LECTURER APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT

DOL H1B-Gulf Coast Ready To Work Petrochem Grant

HCC Practical Nursing Program Initial Application for Admission

This is a Legal Document. By completing and signing, this you certify under

DOL H1B-Gulf Coast Ready To Work Petrochem Grant

RENTAL APPLICATION. Get Involved

Transcription:

1

North Carolina A&T State University Undergraduate Admissions Application Instructions Thank you for your interest in North Carolina A&T State University! Please complete the admissions application carefully, and thoroughly, to ensure that your application receives full consideration. Please note the important deadlines for the admissions process. Application & Documents Deadlines (All applications and documents must be postmarked by the printed date.) Freshmen & Transfer Domestic Students Fall Application Deadline: June 30 Fall Documents Deadline: June 30 Spring Application Deadline: December 1 Spring Documents Deadline: December 15 Freshmen & Transfer International Students Fall Application Deadline: June 1 Fall Documents Deadline: June 20 Spring Application Deadline: October 1 Spring Documents Deadline: October 20 Additional Application Items Please use black ink when completing the application. Answer all questions completely and accurately. If you claim to be a North Carolina resident for tuition purposes, you will need to complete the residency process with the Residency Determination Service (RDS) at www.ncresidency.org. You will receive a Residency Certification Number (RCN) which can be entered onto your admissions application. Standardized testing scores (ACT, SAT, TOEFL, IELTS) must be officially reported to N.C. A&T by the testing agency. o SAT Code: 5003 o ACT Code: 3060 Required Documents for Admission (all students) include: o Admissions Application (completed) o Official High School Transcript o Official College Transcripts (if applicable) o Official Standardized Test Scores (SAT and/or ACT) o International Evaluation of Coursework All International applicants must have your international high school and college transcript/s evaluated by one of the approved credential evaluation services. All post-secondary education coursework must have a course-by-course evaluation. A non-refundable application fee payment of $55 is required to complete your admissions application. It can be paid via check or money order drawn on either a US bank or on a US dollar account. Checks or money orders should be made payable to N.C. A&T State University. The University will also accept the following official fee waiver forms as a payment method: College Board, ACT or NACAC. Copies of waiver forms will not be processed. Additional Application Items (cont.) Need Help? Mail the application, fee payment, and official transcripts to: Office of Undergraduate Admissions North Carolina A&T State University Webb Hall, Lower Level 1601 East Market Street Greensboro, NC 27411 For assistance with the application process, please contact us via phone at 800-443-8964 or via email at uadmit@ncat.edu. North Carolina Agricultural and Technical State University (N.C.A&T) is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award baccalaureate, master s and doctoral degrees. Contact the Southern Association of Colleges and Schools Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097, or call 404-679-4500 for questions about the accreditation of N.C. A&T. N.C. A&T does not discriminate against any person on the basis of age, color, disability, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, veteran status, or any other basis protected by law. For inquiries regarding non-discrimination policies, contact the Title IX Coordinator at titleixcoordinator@ncat.edu. N.C. A&T is an AA/EEO- and ADA-compliant institution.

Print in Black Ink 1. Entering Term: Fall Spring Year 2. First Name Middle Name Last Name Suffix Preferred Name 3. Social Security Number: / / *Disclosure of the applicant s Social Security Number is voluntary, and is requested herein for record-keeping purposes. Please be aware that financial aid, employment, and reporting of tuition and related expenses for tax purposes cannot be processed without submission of a valid Social Security Number. 4. Have you previously applied for admission to N.C. A&T: Yes No Term Year 5. Did your mother or father attend college? Yes No If yes, please list college attended: 6. Did your mother or father graduate college? Yes No 7. Are you related to anyone who has graduated from N. C. A&T? Yes No Name: Graduation Year: Relationship: 8. Are you currently enrolled in High School? Yes No 9. Enrollment Type: New Freshman New Transfer International Freshman International Transfer 10. First Choice Major: Second Choice Major: 11. Sex: Male 12. Ethnicity: Are you Hispanic or Latino? Yes No Female (Hispanic/ Latino: Mexican, Puerto Rican, Cuban Central or South American or other Spanish origin or culture, regardless of race.) 13. Race: Select one or more of the following racial categories: American Indian or Alaska Native Black or African American Native Hawaiian or Other Pacific Islander Asian White 14. Permanent Mailing Address Street Address Apt. No. City/ Town State Zip Code County (or Province) ( ) ( ) Date of Birth: / / Mo Day Year Place of Birth (City/State) County of Residence (Currently) 15. Current Mailing Address (Leave blank if same as permanent address) Street Address Apt. No. City/ Town State Zip Code County (or Province) 3

16. Are you a US Citizen? Yes No If Not: Country of Citizenship: 17. Are you a Permanent U.S. Resident? Yes No Citizenship Status Visa Type: Visa #: Date of Issue: Date of Expiration: If you have an INS SEVIS number, please enter it here: Did another institution issue a Form I-20 (for F, J, or M visa) used for your last entry to the U.S.? 18. Have you been a legal resident of North Carolina for the past 12 months for tuition purposes? Resident of North Carolina (Please complete residency application on page 7) Not a Resident of North Carolina 19. State of Residency: 20. Family Information Parent 1: Last Name First Name Middle Name Street Address City State Zip Code ( ) ( ) Parent 2: Last Name First Name Middle Name Street Address City State Zip Code ( ) ( ) Guardian: Last Name First Name Middle Name Street Address City State Zip Code ( ) ( ) Spouse: Last Name First Name Middle Name Street Address City State Zip Code ( ) ( ) 4

21. High School Information High School Code High School Name Graduation Date: / City/Town State Zip Code Mo Year 22. Attended From Date: / / 22. Attended To Date: / / Mo Day Year Mo Day Year 23. College Information College Code College/University Location Date of Attendance Number of Hours Degree Yes No If yes, type of Degree 24. Non-Continuous Enrollment Please answer the following questions with regard to any school that you have attended (this includes high school, technical institute, college/university). a. During the school year, have you been out of school for reasons other than routine vacations, disability-related reasons, or school related activities? Yes No b. Has it been 3 months or more since you graduated, or since you have been enrolled in school? Yes No If you answered yes to either question above, please explain the circumstances below. Please be as thorough and detailed as possible. c. Did you receive a General Education Development (GED) certificate? Yes No d. Did you receive an Adult High School Diploma? Yes No GED (General Educational Development) Tests measure the outcome of high school education and determines if a student can score at the twelfth grade completion level in language arts writing, social studies, science, language arts reading and mathematics. (Offered to students who did not graduate from high school) AHSD (Adult High School Diploma) Adults who did not complete their high school education but earned a high school diploma from a secondary school. An adult may earn a North Carolina Adult High School Diploma by completing twenty (20) units and by passing the North Carolina Competency Test in mathematics and reading. (Offered to students who did not graduate from high school) 5

25. Campus Safety Questions (Required) In an effort to maintain a safe learning community, we must ask the following questions of all applicants. For the purpose of the following questions, crime or criminal charge refers to any crime other than a traffic related misdemeanor or an infraction. You must, however, include any alcohol or drug related offenses whether or not they are traffic related incidents. Answering yes to any of the following questions may not necessarily preclude your being admitted. However, failing to answer these questions, or failing to respond completely, accurately, and truthfully, may be grounds to deny or withdraw your admission or to dismiss you after enrollment. If you answer yes to any of these questions, please provide a written explanation that gives the approximate date of each incident, explains the circumstances, and reflects on what you learned from the experience. The university reserves the right to require an additional statement from an appropriate official corroborating your account, either before acting on your application or before permitting you to enroll. Your failure to provide such a statement upon request may be grounds to deny or withdraw your admission or to dismiss you after enrollment. You are required to notify the university immediately and in writing of any new or pending criminal charge, any disposition of a criminal charge, or any school, college, or university disciplinary action against you, or any type of military discharge other than an honorable discharge, or any non-routine absence from school, that occurs at any time after you submit this application and prior to enrollment. Your failure to do so may be grounds to deny or withdraw your admission or to dismiss you after enrollment. 1. Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct that resulted in your probation, suspension, removal, dismissal, or expulsion from the institution? Yes No 2. Have you ever been adjudicated guilty or convicted of a misdemeanor, felony, or other crime? Yes No [Note that you are not required to answer yes to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise ordered by a court to be kept confidential.] 3. Do you have any criminal charges pending against you? Yes No 4. Have you entered a plea of no contest or nolo contendere, or an Alford plea, to a misdemeanor, felony, or other criminal charge; or received a deferred prosecution or prayer for judgment continued for such a charge; or otherwise accepted responsibility for such a crime? Yes No 5. Have you received any type of discharge from military service other than an honorable discharge? Yes No Never Served No Currently Serving No Honorably Discharged 6. If your education was or will be interrupted, indicate here and provide details. 26. Signature By signing this application, I agree to abide by the policies and regulations of North Carolina A&T State University and to the best of my knowledge, the information I have given is true. I understand that any misrepresentation of facts on the application will be cause for refusal of admission, cancellation of admission, or suspension from the university. Signature Date (If under 18 years old) Parent/Guardian Signature Date 6

RESIDENCY DETERMINATION FOR TUITION PURPOSES Your residency for tuition purposes determines your in-state or out-of-state status and may impact your admission, tuition, scholarship or financial aid eligibility. North Carolina residency for tuition purposes is governed by North Carolina state law. More information about North Carolina residency for tuition purposes can be found at www.ncresidency.org. Do you claim to be a North Carolina Resident? Yes No I claim to be a North Carolina resident for tuition purposes. I do not claim North Carolina residency for tuition purposes. I understand I will be charged the non-resident tuition rate if enrolled at a North Carolina state-supported institution. If you claim to be a resident, you must complete the residency process with the Residency Determination Service (RDS) at www.ncresidency.org. You will receive a Residency Certification Number (RCN) which should either be entered onto your admissions application or provided directly to your Admissions Office, when available. ENTER YOUR RCN HERE

Military Status for Financial Aid and Residency Determination A. Are you currently serving or have you ever served in the United States Armed Forces? Yes No I choose not to answer this question B. Are you a dependent or spouse of a current or prior United States service member? Yes No I choose not to answer this question IF YOU ANSWERED YES TO QUESTION A, PLEASE COMPLETE THE FOLLOWING IF YOU CURRENT LY SERVE OR HAVE EVER SERVED IN ANY BRANCH OR STATUS IN THE UNIT ED STATES ARMED FORCES. THIS IN FORMATION WILL HELP US CONNECT YOU WITH FINANCIAL AID BENEFITS AND DETERMIN E YOUR ELIGIBILITY FOR IN -STAT E RESIDENCY. 1. What is your current status? Active-duty NC National Guard Other National Guard Reservist Separated Veteran Retiree 2. Branch of Service: Army Air Force Navy Marine Corps Coast Guard 3. Current or last pay grade: E-1 E-2 E-3 E-4 E-5 E-6 E-7 E-8 E-9 O-1 O-2 O-3 O-4 O-5 O-6 O-7 O-8 O-9 O-10 O-11 W-1 W-2 W-3 W-4 W-5 4. Do you plan to use military or veterans educational benefits while enrolled at this institution? Yes No Not Sure If yes, which benefit do you plan to use? Chapter 30 Montgomery GI Bill Chapter 31 Vocational Rehabilitation Chapter 33 Post 9/11 GI Bill Chapter 35 Dependents Education Assistance (DEA) Chapter 1606 Selected Reserves GI Bill Chapter 1607 Reserves Education Assistance Program (RE AP) Military Tuition Assistance Military Spouse Career Advancement Accounts (MyCAA) Marine Gunnery Sgt. John David Fry Scholarship Not sure 5. Your current or last permanent duty station: Fort Bragg Camp Lejeune MCAS Cherry Point MCAS New River Pope Army Airfield Seymour Johnson AFB USCG North Carolina Other installation outside of NC NC National Guard Other National Guard Reservist Other duty stations in North Carolina 6. Your current or last home of record: 7. Your state of legal residence last claimed on your DD Form 2058 (State of Legal Residence Certificate): 8. Date of initial entry into military service: 9. Discharge or retirement date (actual or anticipated): 10. If discharged or retired, your final duty station: Fort Bragg Camp Lejeune MCAS Cherry Point MCAS New River Pope AFB Seymour Johnson AFB USCG North Carolina Other installation outside of NC NA NC National Guard NA Other National Guard NA Reservist IF YOU ANSWERED YES TO QUESTION B, PLEASE COMPLETE THE FOLLOWING IF YOU ARE THE DEPENDENT OR SPOUSE OF SOMEONE CURRENT LY SERVING OR WHO HAS EVER SERVED IN ANY BRANCH OR STATUS IN THE UNIT ED STAT ES ARMED FORCES. THIS INFORMATION WILL HELP US CONNECT YOU WITH FINANCIAL AID BENEFITS AND DETERMINE YOUR ELIGIBILITY FOR IN -STAT E RESIDENCY. Please respond to these questions in reference to the connected service member. 1. Your relationship to the service-member or veteran: Dependent Spouse 2. Current status of service member: Active-duty NC National Guard Other National Guard Reservist Separated Veteran Retiree Deceased 3. Branch of Service of service member: Army Air Force Navy Marine Corps Coast Guard NOAA Commissioned Corps Public Health Service Commissioned Corps 4. Current or last pay grade of service member: E-1 E-2 E-3 E-4 E-5 E-6 E-7 E-8 E-9 O-1 O-2 O-3 O-4 O-5 O-6 O-7 O-8 O-9 O-10 O-11 W-1 W-2 W-3 W-4 W-5 7

5. Do you plan to use United States Department of Defense or veterans educational benefits while enrolled at this institution? Yes No Not Sure If yes, which benefit do you plan to use? Chapter 33 Post 9/11 GI Bill Chapter 35 Dependents Education Assistance (DEA) Military Spouse Career Advancement Accounts (MyCAA) Marine Gunnery Sgt. John David Fry Scholarship Not sure 6. Current or last permanent duty station of service member: Fort Bragg Camp Lejeune MCAS Cherry Point MCAS New River Pope Army Airfield Seymour Johnson AFB USCG North Carolina Other installation outside of NC NC National Guard Other National Guard Reservist 7. Current or last home of record of service member: 8. What is/was state of legal residence the service member last claimed on his/her DD Form 2058 (State of Legal Residence Certificate)? 9. Date of initial entry into military service for service member: 10. Discharge or retirement date of service member (actual or anticipated): 11. If discharged or retired, service member s final duty station: Fort Bragg Camp Lejeune MCAS Cherry Point MCAS New River Pope AFB Seymour Johnson AFB USCG North Carolina Other installation outside of NC NA NC National Guard NA Other National Guard NA Reservist Thank you for your interest in North Carolina A&T State University! 8