Undergraduate Online Application for Admission

Application Instructions for Urbana University

1. Complete all parts of the application form.

2. Ask your guidance counselor to forward an official copy of your high school transcript. Be sure that test scores, class rank and a list of senior courses are included.

3. If you participated in the post-secondary education option program, please feel free to contact the registrar at the college/university you attended and request an official transcript be sent to the Urbana University Office of Admissions.

4. List the name and contact information of a person who can attest to your academic ability such as a teacher, guidance counselor or principal as your reference. In some cases, this person may need to be contacted to make a final decision on an applicant's file.

5. ACT or SAT I scores are required for consideration for all degree candidates. The Urbana University code for the ACT is 033460 and the SAT is 1847.

6. Send application to the Office of Admissions with the $25 non-refundable application fee. Students who visit our campus or attend one of our Visit Days will receive an application fee waiver (see below).

7. If you indicate an interest in applying to the Honors College, your application will be sent to the Director of the Honors College after you have been accepted to Urbana University. An on-campus interview will be arranged. Following the interview with members of the Honors College Faculty Committee, you will be asked to write an essay.

8. International students - Please request from the Office of Admissions an International Student Application or apply online.

9. Please mail the $25 application fee to The Office of Admissions, 579 College Way, Urbana, OH 43078 or call with a credit card payment to 937-484-1356 or 1-800-787-2262 ext. 1356.

Your application will not be evaluated without the complete application, official transcript, ACT or SAT scores and the $25 application fee.

Application Status:

Student Classification:

Term You Wish to Enter:

Fall (August) 20
Spring (January) 20
Summer (May or June) 20

Personal Data:

Name (Last Name, Legal First Name, MI):

Preferred Given Name or Nickname:

Permanent Home Address (Number and Street):

City, State/Province:

Zip Code:

County (i.e. Champaign):

Country:

Home Phone (area code - ### - ####):

Mobile (Cell) Phone (area code - ### - ####):

Date of Birth (mm/dd/year):

Place of Birth:

Email (Required):
Note: form will not be processed without a valid e-mail address

IM Address :

IM Type :

Preferred Method of Contact:

Home Phone
Mobile Phone
Email
IM
Mail

Reference:

Name:

Street Address:

City, State/Province:

Zip Code:

Title:

Phone (area code - ### - ####):

Email address:

Family Data:

Name of father/guardian/spouse (Last, First, MI):

Street Address:

City, State/Province:

Zip Code:

Occupation:

Place of Employment:

Home Phone (area code - ### - ####):

Mobile Phone (area code - ### - ####):

Email address:

College Attended:

Year Graduated:

Name of mother/guardian/spouse (Last, First, MI):

Street Address:

City, State/Province:

Zip Code:

Occupation:

Place of Employment:

Home Phone (area code - ### - ####):

Mobile Phone (area code - ### - ####):

Email address:

College Attended:

Year Graduated:

With whom do you live:

Mother and Father
Mother
Father
Guardian
Spouse
Other:

Names and ages of other siblings/children in your family:

Please list family members who have attended or are currently attending Urbana University:

Name:

Relationship:

Date attended/attending:

Name:

Relationship:

Date attended/attending:

Educational Data:

High School you attend now/graduated from:

Street Address:

City, State/Province:

Zip Code:

ACT/CEEB code number (optional):

Date of High School Graduation:

Is/was your school :

Public
Private

Obtained GED?

Yes
No
If yes, when?

Please list below any colleges, universities, or post-secondary schools you have attended; this includes any college attended for post-secondary education option (PSEO) courses.

Official transcripts must be received before you can be considered for admission. Have an official college transcript mailed directly to our Admissions Office. No evaluation will be made until these transcripts are received.

First Institution

(Leave blank if not applicable)

Name

City, State/Province

Dates of Attendance

Degree(s) Received

PSEO course?

Yes
No

Second Institution

(Leave blank if not applicable)

Name

City, State/Province

Dates of Attendance

Degree(s) Received

PSEO course?

Yes
No

Third Institution

(Leave blank if not applicable, if PSEO please indicate under Degree Received)

Name

City, State/Province

Dates of Attendance

Degree(s) Received

PSEO course?

Yes
No

Current Status: If you are not currently attending a school, please describe your activities since you were last enrolled (example: work, travel, etc.):

Scholastic Aptitude Test (SAT) or American College Test (ACT) is required. (An official test score report is required)

SAT

Was taken
Will be taken
Date:
Score if known: Verbal: Math:

ACT

Was taken
Will be taken
Date:
Score if known: E: M: R: SR: C:

Programs of Study:

Please select the program of study 1st choice:

Please select the program of study 2nd choice:

Business Administration	Criminal Justice	Psychology
... Accounting	Education	Science
... General Management	... Early Childhood Development Educ.	... Biology
... Human Resource Management	... Early Childhood Education	... Chemistry
... Marketing	... Middle Childhood Education	... Pre-Dentistry
Communications	... Adolescent/Young Adult Education	... Pre-Medicine
... Business Marketing Communications	.. Intervention Specialist	... Pre-Veterinary
... Journalism/Public Relations	English	Sociology
... Theatre	Family Studies	Sports and Health Studies
Computer Information Systems	History	... Athletic Training
... Computer Programming	Liberal Studies	... Exercise Science
... E-business	Mathematics	... Recreation
... Management Information Systems	Philosophy and Religion Studies	... Sports Management
... Systems Analysis and Design	Political Science	... Coaching Certificate
... Systems and Network Administration	... Pre-Law	Undecided

Honors College:

I AM INTERESTED IN APPLYING TO THE URBANA UNIVERSITY HONORS COLLEGE (please check)
Yes
No

Academic Honors

Please list all academic achievements and awards earned:

Extracurricular and Community Activities

Please share information with us describing your extracurricular and community activities. You may also include special interests, events or achievements and offices held:

Indicate intercollegiate sports in which you plan to participate in college:

Baseball
Basketball
Cheerleading
Cross Country
Football
Golf
Soccer
Softball
Swimming
Volleyball
Other:

Indicate other activities in which you plan to participate in college:

Band/Color Guard
Choir
Drama/Theatre
Intramural sports
Newspaper
Other:

Financial Assistance Information

Do you plan to apply for financial