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PERSONAL INFORMATION(Please type or print clearly in ink.)1. Legal namePreferred first nameSocial Security (optional)2. Other name(s) records may be listed under (maiden) Email address @3. Date of birth / / Male Female Marital status4. Religious affiliation (optional)5. EthnicityDo you consider yourself to be Hispanic/Latino? Yes NoIn addition, please select one or more of the following racial categories to describe yourself:Asian Black or African American Native Hawaiian or Pacific Islander WhiteLanguage spoken in your household6. Citizenship Country of birth6a. Applies to non-U.S. citizens onlylast first middle Jr., II, etc.m d yAre you a permanent U.S. resident? Yes No Country of legal/permanent residencyIf no, and you are not a U.S. citizen, you need to complete the international application for undergraduate admission.7. Are you a veteran of the US Armed Services? Yes NoAmerican Indian or Alaskan Native8. Home addresshouse number and streetcity state zip code country county/provinceMailing addresshouse number and streetcity state zip code country county/provinceMailing address valid fromtomonth/yearmonth/year9. Home phone ( ) Mailing address phone ( ) Cell phone ( )10. Please indicate if you are willing to accept text messaging: Yes NoACADEMIC/ENROLLMENT INFORMATION11. I am applying for the (check one) Fall semester 20 Spring semester 2012. I am interested in the following academic major. See inside back cover of application for a complete listing of majors.orUndecided13. High school you most recently attended (or graduated)Date of entry Address CEEB/ACT codecity state zipDate of graduation / Type of school public private parochial home schoolmonth yearGuidance counselor ’s namePosition

COUNSELOR RECOMMENDATION AND SECONDARY SCHOOL REPORT(Freshman applicants only; a teacher recommendation may be substituted.)Student’s nameSocial Security number (optional)Have your high school guidance counselor complete this section.Counselor nameHigh school nameTitleSchool CEEB codeTelephone number ( ) Fax number ( ) EmailPercentage of students who attend: four-year two-year institutions.Grading scale: 4.0 100 Other Passing grade isStudent’s cumulative GPA Weighted UnweightedGrade point average includes (check all that apply): 9th grade 10th grade 11th grade 12th gradeStudent ranks in a class of as of: 9th grade 10th grade 11th grade 12th gradeWe do not rank.Compared to other college-bound students at this school, the student’s curriculum is:Most demanding Very demanding DemandingAverageBelow averageDo you recommend this student for admission to Xavier University?Highly recommend Recommend Recommend with reservationDo not recommend Unable to judge Prefer not to respond Please callCOUNSELOR STATEMENT(Please state any evidence to support your recommendation of this student using the space provided or using additional paper. Your comments shouldaddress the student’s academic ability, personal character and all information relevant to the student’s ability to perform college-level work.)To the best of my knowledge, the information included in this application is complete and accurate.Counselor signatureDatePlease include the school profile, application fee or fee-waiver, official transcripts and ACT or SAT results. Mail to:Xavier UniversityOffice of Admission3800 Victory ParkwayCincinnati, Ohio 45207-5131Questions?Call 877-XUADMIT (877-982-3648) or 513-745-3301Fax 513-745-4319xuadmit@xavier.eduXavier University is an academic community committed to equal opportunity for all persons regardless of age, sex, race, religion, handicap or national origin.

XAVIER UNIVERSITY MAJORSAcademic programs are housed in three colleges: Arts and Sciences; Social Sciences, Health, and Education; and the WilliamsCollege of Business.College of Arts & SciencesActuarial ScienceAdvertisingApplied Biology (Forestry)Applied Chemistry (Pre-Engineering)Applied Physics (Pre-Engineering)ArtBiologyChemical ScienceChemistryClassical HumanitiesClassicsCommunication Arts - UndecidedCommunication StudiesComputer ScienceEconomics (BA)Electronic MediaEnglishEnvironmental ScienceFine ArtsFrenchGermanHistoryInternational Studies - EuropeInternational Studies - Intl BusinessInternational Studies - Latin AmericaInternational Studies - Post ColonialLife Sciences for BusinessMathematicsMedical TechnologyModern Languages and International EconomicsMusicMusic EducationNatural Sciences (Pre-Med)PhilosophyPhysicsPolitical SciencePre-PharmacyPublic RelationsSociologySpanishTheologyUndecidedCollege of Social Sciences,Health, and EducationAthletic TrainingCriminal JusticeEarly Childhood EducationEducation - UndecidedHealth Services - Information ManagementHealth Services - Long Term CareMiddle Childhood EducationMontessori EducationNursingOccupational TherapyPsychologyRadiologic TechnologySocial WorkSpecial EducationSport ManagementSport MarketingTeaching Biology and General ScienceTeaching Chemistry and General ScienceTeaching Life SciencesTeaching Life Sciences and ChemistryTeaching Life Sciences and PhysicsTeaching Physical SciencesWilliams College of BusinessAccountingBusiness - UndecidedEconomics (BSBA)Entrepreneurial StudiesFinanceInformation SystemsInternational BusinessManagementMarketingStrategic Human Resource Management

IMPORTANT DATES AND DEADLINESADMISSION FOR FALL SEMESTER 2012October 2011Jan. 1, 2012Feb. 15, 2012May 1, 2012Application review process begins foradmission and scholarships.Submit the Free Application for Federal StudentAid (FAFSA) as soon as possible after this date;Xavier’s code is 003144.Priority deadline to submit the FAFSA.Postmark deadline to submit tuition andhousing deposits to confirm enrollmentat Xavier for fall semester.June 15, 2012Aug. 1, 2012Dates listed are postmark deadlines.For community college graduates only—deadline to apply for admission and beconsidered for Phi Theta Kappa scholarship.Phi Theta Kappa students do not need to submita separate application.Deadline to apply for admission and beconsidered for the transfer scholarship.SCHOLARSHIP OVERVIEWTransfer applicants who have achieved a 3.00 cumulative college GPA will be offered a transfer scholarship. Applicants who have achieved a 2.70-2.99 cumulative GPA will be offered the transfer achievement award. A separate scholarship application is not required. All transfer applicants areautomatically considered. To ensure consideration, all application credentials for fall must be postmarked by Aug. 1, 2012.

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