Concurrent Enrollment Program
Application for Admission
University of South Carolina Aiken
Office of Admissions
471 University Parkway
Aiken, South Carolina 29801
Please complete this application and return it to the Office of Admissions. A non-refundable $10 application fee is required.
Social Security #: ______________________
Term you wish to enroll: Fall 20_____
Spring 20_____
Name (print): ____________________________________________________________________________
(Legal Last Name)
(Legal First Name)
(Middle)
(Suffix Jr., II, III, etc.)
Address: _______________________________________________________________________________
City: __________________________________________ State: ___________ ZIP: ___________________
County: ___________________________ Student e-mail address: _________________________________
Home phone: _____________________________ Student cell phone: _____________________________
(area code)
(area code)
□ Male □ Female
Date of birth: _______________________
Parent name(s): __________________________________ Parent phone: __________________________
Parent e-mail: ____________________________________
Are you a U.S. citizen? □ Yes
□ No
If no, what is your country of citizenship?: __________________________
If no, what is your immigration status in the U.S.?: __________________________
If no, are you a legal immigrant (permanent resident alien) of the U.S.?
□ Yes □ No
(Note: for citizenship verification, you must submit a copy of your South Carolina drivers license, birth certificate, or passport.)
Name of High School: _______________________________
Expected Year of HS Graduation: 20_____
Have you been named a USCA Scholar? □ Yes
Which standardized test(s) have you taken?
□ No
□ SAT □ PSAT □ ACT □ PLAN
USC Aiken is required to collect information on the ethnic and racial composition of its student body and report this information to the
U.S. Department of Education. Admissions decisions are not affected by ethnic background.
Do you consider yourself to be either Hispanic, Latino or of Spanish origin?
□ Yes □ No
Please select one or more of the following groups with which you identify:
□ American Indian or Alaska native
□ Asian
□ Black
□ Native Hawaiian or Pacific Islander
□ White
RESIDENCY: List the city, county, and state where you have physically resided for the past five years (list
dates).
_____________________________________________________________________________
City
County
State
from month/year
to present
_____________________________________________________________________________
City
County
State
from month/year
to month/year
_____________________________________________________________________________
City
County
State
from month/year
to month/year
Requested USC Aiken course(s)
Students should select courses based on consultation with USC Aiken and/or high school counselor
List course number – Example ATHE 161 or AFYS 101
FALL 20_____
FIRST CHOICES
1
2
SPRING 20_____
FIRST CHOICES
1
2
ALTERNATE CHOICES
1
2
ALTERNATE CHOICES
1
2
Student signature/certification
Read this statement carefully and sign your name.
I am requesting permission to pursue Concurrent Enrollment at the University of South Carolina Aiken. I am
not seeking admission as a degree candidate. I understand that I must be admitted as a regular, degreeseeking student before this credit may be applied toward a USCA degree. I accept the condition that I am
subject to all standard University academic regulations as stated in the University Bulletin.
I have truthfully disclosed my citizenship status and understand that any omission or misrepresentation may
cause dismissal from the University in keeping with South Carolina immigration law.
I certify that all the information provided here is accurate, complete, and without omission; and I understand
that any falsification is cause for immediate cancellation of my registration. I understand that all credentials
become the property of USCA and are nonreturnable.
Signature ___________________________________________________ Date __________________
Parental permission
As the parent/guardian of _____________________________ , I approve of my child enrolling in a course(s)
at the University of South Carolina Aiken. I understand that the course(s) are college-level material in which
textbooks, assignments and discussions may include adult and sometimes controversial subjects. Further, I
understand that my child will be required to meet all of the study requirements as called for on the course
syllabus and am aware that I need to familiarize myself with the program of study and the expectations to be
fulfilled in order to insure my child's success at USC Aiken.
Signature ____________________________________________ Relationship ________________________
Date ____________ E-mail address _________________________________________________________
High School permission
I certify that __________________________________ has the appropriate standardized test scores (SAT/
PSAT/ACT/PLAN), and either class rank (top 25%) or grade point average (3.5+ UGS) and is eligible to
concurrently enroll for a semester at the University of South Carolina Aiken for university-level classes and
has permission to enroll as indicated. I have provided USCA with an official transcript for this student.
High School Counselor/Principal (Print Name) _________________________________________
Signature ______________________________________________________ Date __________
Notes
The following documents must also be received by the Office of Admissions before acceptance is considered:
1) A completed/signed application for admission
2) $10 application fee
3) Official high school transcript
4) Official standardized test scores (scores on official high school transcripts are considered official)
5) College transcript(s) (if applicable)
6) Signed clearance from designated high school official authorizing your participation
7) Signed clearance from parent on "permission statement"
8) Placement scores may be required for enrollment in some courses
South Carolina Illegal Immigration Reform Act: Each student admitted to USC Aiken will have his/her citizenship and/or immigration
status checked with the federal government to ensure (s)he is lawfully present in the United States. Those found to be in the U.S.
unlawfully will not be allowed to attend the institution.
The University of South Carolina Aiken does not discriminate in educational or employment opportunities or decisions for qualified persons on the basis of race, color, religion, sex, national origin, age,
disability, sexual orientation, or veteran status. This policy extends to all programs and activities supported by the University. The University of South Carolina Aiken is accredited by the Commission
7/09
on Colleges of the Southern Association of Colleges and Schools to award baccalaureate and masters degrees.