Application for Undergraduate Admission

Student Information

Last Name:

First Name:

Middle:

Suffix (Jr., etc.):

Gender male female

Date of Birth (mm/dd/yyyy) / /

Mailing Address

Number and Street
City
State or Province	Postal Code
Country

Phone (Country Code, Area Code, Phone):

E-mail Address (We will update your status through Email)

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Do you wish to Identify yourself as a member of any of the following groups?
Yes No

If so, which?
African American
Asian/Pacific Islander
Caucasian/White
Hispanic/Latino
Native American (Tribal Group)
Other

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When are you applying to enter Miskatonic University?
Fall Term Spring Term

You are applying as a  Freshmam  transfer

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Applicants to the music program at the Pickman Art Insitute:
please indicate the instrument for which you plan to audition.

Citizenship

Are you a United States citizen? Yes No

If not, do you currently hold a United States Permanent Resident or Immigrant Visa ("green card")?
Yes No

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Is English the primary language spoken in your home?*
Yes No
If not, what is?

*Note: If English is not the primary language spoken in your home or if you are not a native speaker of English, you must take the Test of English as a Foreign Language (TOEFL. For further information contact: TOEFL, Educational Testing Service, CN 6154, Princeton, New Jersey 08541-6154, U.S.A.

Miskatonic University Affiliations

Is either parent a full-time employee of Miskatonic University? Yes No

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If a member of your family is or has been an undergraduate or graduate student at Miskatonic University, please complete the following.

Name (Include maiden name, if applicable)	College and year(s) of attendance	Year of graduation	Relationship to you

Financial Aid

Will you be applying to Miskatonic University for financial aid? Yes No

Note: Timely submission of the necessary financial aid forms may allow us to notify you of our admission and financial aid decisions at the same time.

Residence Information

You are planning to live in a University residence commute

Freshmen are required to live on campus unless they reside with a parent or spouse, or unless they will have reached the age of twenty-one by October 1 of their freshman year. Freshmen who have not reached the age of sixteen by September 1 of their freshman year cannot live on campus.

High School/College Information

Give the full name and address of your present high school or college, or of the institution you attended most recently. Please obtain the College Board code from your guidance or registrar's office. Codes are required for all United States schools.

High School/College	College Board Code
Number and Street	City	State	Zip Code

Standardized Testing

Please list the dates on which you took or are planning to take the following:
SAT I: Reasoning Test (mm/dd/yyyy)
/ / Most recent
/ / Scheduled
ACT
/ / Most recent
/ / Scheduled

Note: Please make sure your official score report is sent directly to us from the appropriate testing service.

Other Schools and Colleges You Have Attended

Beginning with the ninth grade, please list every secondary school, postsecondary school, college, or vocational school you have attended.

Name of school	City/State		Dates of attendance	Diploma or degree received
			/ to /
			/ to /
			/ to /
			/ to /

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If you have not attended one of the institutions listed above within the last six months, please indicate how you have spent your time (for example; travel, work).

Have you ever been expelled, suspended, dismissed, or had any disciplinary action taken against you by an educational institution?

Yes No

If yes, why? Please limit your response to two lines.

Transfer Candidates Only

How many credits or semester hours have you completed to date?
What is your cumulative GPA?
Your GPA for the last semester you completed?

List each college or university attended, beginning with the institution most recently attended.
Transcripts must be sent from each institution.

College/University College Board Code:
College/University College Board Code:
College/University College Board Code:

Activities

Please list your school, community, athletic, or other activities, beginning with the one most important to you.

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Activity	Office(s) held or honor(s) received	Hours per week

Additional Information

Miskatonic University encourages qualified students with disabilities to apply for admission. You may voluntarily request information about available services by writing to the Office of Disability Services at 23 Highwater Street, Arkham, Massachusetts 01924, or by checking the appropriate box below. Your inquiry will be confidential and will not affect your eligibility for admission.

Blind/visually impaired	Deaf/hearing impaired
Learning disabled	Mobility impaired

Essay Section

Essay Section: This section of the application gives you an opportunity to present yourself in a way that grades and test scores cannot. The Board of Admissions uses your essay to determine your ability to organize thoughts and express yourself clearly. Accordingly, we ask that you prepare this work entirely on your own.

How did you become interested in Miskatonic University?

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Write an essay of no more than 500 words on any subject that interests you. For example,you may choose to write on an issue about which you feel strongly, an experience that has greatly influenced your life, or other circumstance that you would like the Admissions staff to consider in reviewing your application. These are only suggestions, however; the choice of topic is yours.

Press Submit to submit your completed application.

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