download a PDF application - Marymount University
download a PDF application - Marymount University
download a PDF application - Marymount University
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MARYMOUNT UNIVERSITY<br />
Undergraduate Application<br />
Office of Admissions · 2807 North Glebe Road, Arlington, Virginia 22207-4299 · Phone: (703) 284-1500 · Fax: (703) 522-0349<br />
Complete this <strong>application</strong>, or apply online at www.marymount.edu/apply<br />
APPLICANT INFORMATION<br />
Mr. Mrs. Ms. Miss Dr.<br />
Date _________________________<br />
Name ______________________________________________________________________________________________________________________________________________________________<br />
Last/Family/Surname First/Given/Personal Middle Maiden<br />
PERMANENT HOME ADDRESS<br />
CURRENT ADDRESS (IF DIFFERENT FROM PERMANENT ADDRESS)<br />
________________________________________________________________________________ __________________________________________________________________________________<br />
Number and Street Apt. Number and Street Apt.<br />
________________________________________________________________________________ __________________________________________________________________________________<br />
City State ZIP Country City State ZIP Country<br />
( ) _________________________ ( ) _________________________ ( ) _________________________<br />
Phone Cell Phone<br />
Email _________________________________________________________________________<br />
Social Security #________________________________________________________________<br />
Male Female Birthdate ___________________________________________ Birthplace_______________________________________________________________________<br />
Religion (optional)___________________________________________________________ Is English your first language? Yes No<br />
Please send all correspondence to my permanent address my current address (valid until ____________)<br />
Are you a U.S. citizen? Yes No (If no, please complete the shaded section below.)<br />
What is your country of citizenship?_______________________________<br />
Are you a U.S. permanent resident? Yes No<br />
If yes, please include a photocopy of your Green Card with your completed <strong>application</strong>.<br />
If no, what is your visa type?_____________________________________<br />
Have you previously applied to <strong>Marymount</strong> <strong>University</strong>? No Yes Application date _____________________________<br />
Have you previously attended <strong>Marymount</strong> <strong>University</strong>? No Yes From ___________ to ____________ Student Number____________________________<br />
We request the following information in compliance with Title VI of the Civil Rights Act. Your response is voluntary and has no bearing on the<br />
admission decision:<br />
Ethnicity: Hispanic/Latino Non-Hispanic/Latino<br />
Race (please check all that apply): American Indian, Alaska Native Asian Black, African American<br />
Hawaiian or other Pacific Islander White<br />
ENROLLMENT INFORMATION<br />
Semester/year you plan to enroll Fall 20______ Spring 20______<br />
Attendance status Full time (12 credits or more) Part time (under 12 credits)<br />
Residence status (See Residence Requirement on page 1) Residence hall student Commuter student (local area)<br />
Major (see inside back cover) ______________________________________________<br />
Minor (optional) ______________________________________________________________<br />
Please indicate if you have an educational goal in one of the following areas of interest. (This information is used for academic advising only.)<br />
Education/Teaching Licensure Pre-Law Pre-Medicine Pre-Physical Therapy<br />
Do you intend to apply for financial aid? Yes No<br />
ACADEMIC INFORMATION<br />
List all high schools you have attended. Attach a separate sheet if you need more space.<br />
School City State CEEB code (if known) Dates attended Year graduated<br />
_____________________________________________________________________________________________________________________________________________________________________<br />
_____________________________________________________________________________________________________________________________________________________________________<br />
Name of high school/college guidance counselor ________________________________________________________ Phone (<br />
List dates you have taken — or will be taking — the SAT, ACT, TOEFL, IELTS, or PTE exam.<br />
SAT Date(s) ____________________________________________<br />
If you are not a U.S. citizen or permanent resident,<br />
please complete the required International Student Supplemental<br />
Information (ISSI) form. Download the form at www.marymount.<br />
edu/admissions/international<br />
ACT Date(s) ____________________________________________<br />
TOEFL Date(s) _____________________ IELTS Date(s)_____________________ PTE Date(s)_____________________<br />
)_______________________________________