Non-Matriculating High School Dual-Enrollment Application

Contact the Admissions Office
Non-Matriculating Undergraduate Application for Admission - Formstack

Personal Information

Name*
Dropdown list
Date of Birth*
Numbers only, no dashes
Ethnic Background (Select one or more of the following)
Used for government reporting, will not be used in making an admissions decision
Address*
Select option from the dropdown list
Please call me on my:*
Dropdown list
Social Media
Please check off any social media that you use
Your Facebook Handle (URL)
Your Twitter Handle (URL)
Your Instagram Handle (URL)
Your LinkedIn Handle (URL)

Educational Background

Please list high school currently attending
Of high school
(Month/Year - Month/Year)
If Applicable
If Applicable
If Applicable
List each test and the date you plan to retake it

Background Information

Only one option is required
(Father/Guardian)
(Father/Guardian)
(Father/Guardian)
(Father/Guardian)
(Father/Guardian)
(Father/Guardian)
(Father/Guardian)
(Father/Guardian)
(Father/Guardian)
(Father/Guardian)
Mother/Guardian
Mother/Guardian
Mother/Guardian
Mother/Guardian
Mother/Guardian
Mother/Guardian
Mother/Guardian
Mother/Guardian
Mother/Guardian
Mother/Guardian
Use your mouse or finger to draw your signature above
Date*