UMKC Application for Admission by High School Certification
Social Security number
Last name
First
Middle
Preferred first name Current mailing address: Number and street
City
State
ZIP
Home phone Work phone
Cellphone Date of birth: month/day/year
Email address
County
Residency information
Are you a Missouri resident? m Yes How long have you been a Missouri resident?
m No Place of birth: City
State
Are you a U.S. citizen? m Yes m No; country of citizenship:
If resident alien, card number
Date of issue
Attach a copy of your card.
Are you an international visa student? m No m Yes; type of visa:
If yes, take your passport or visa documents to the UMKC International Student Affairs Office at 5000 Holmes St.
Enrollment information
Have you previously applied to UMKC? m No m Yes; semester and year applied:
Have you previously enrolled at UMKC? m No m Yes; last semester enrolled:
High school certifying your admission
High school name
Specify the semester and year in which you plan to enroll: m Fall
Current high school grade level: m Junior
m Senior
m Winter
Address
m Summer Year ______________
Optional information
Gender: m Male
m Female
To help us better serve our student population, design inclusive programming and remain compliant with federal, state, local and several granting
organizations, please indicate your ethnic or racial background:
Are you Hispanic/Latino? m Yes m No
What do you consider to be your racial background? (Place an ‘X’ next to all that apply, and put a ‘P’ on the line next to your primary ethnicity.)
m_____ American Indian or Alaska Native
m_____ White
m_____ Black/ African-American
m_____ Native Hawaiian or other Pacific Islander
m_____ Asian (underrepresented)
m_____ Nonresident International
m_____ Asian (includes Chinese, Filipino, Japanese, Korean, Asian Indian or Thai)
High school certification
(To be filled out by high school principal or counselor)
This is to certify that
will be a m junior m senior at this high school at the time he/she enrolls at UMKC.
Student name
His/her rank is ________ in a class of ____________________.
Generally applicants must rank in the upper 10 percent of the class, present ACT composite score in the upper 10 percent and have completed the required high school units.
Available college aptitude test scores as follows:
ACT score mE
mM
mR
mS
Composite _________ Date of test ___________________
SAT score mV
m M Date of test ___________________
We recommend that this student take the courses listed below:
School term UMKC course no. Title of course Signature Date
Semester hours
m Principal m Counselor
High school name
Phone
Parent’s signature ___________________________________________ Student’s signature _____________________________________
University of Missouri-Kansas City
Office of Admissions
120 Administrative Center
5115 Oak St.
Kansas City, MO 64112
admit@umkc.edu
816-235-1111
umkc.edu
UMKC is an equal opportunity/affirmative action institution.
Relay Missouri: 800-735-2966 (TTY).
Use this application if you wish to attend the University of Missouri-Kansas
City for only one semester or summer term as a dual credit or visiting student
from high school.
The completed form must be signed by a parent or guardian and your high
school counselor or principal and returned to the UMKC Admissions Office
before the semester begins.
Admission as a certification student is not the same as admission to a
degree program. If you wish to be considered as a freshman, you must submit
a regular UMKC application, a high school transcript with rank in class,
and admissions test scores as outlined in the instruction sheet dealing with
applying for admission to the university.
Nonresident students should refer to the Fees and Expenses section of the
Schedule of Classes/Advisement and Registration Guide (Class Schedule) for
the term for which enrollment is sought for information regarding payment of
out-of-state tuition.
Admission by high school certification does not imply that space is being
reserved for you in the courses you request. Your enrollment will be subject to
the availability of class spaces at the time of your registration.
About the High School Programs
What are the advantages of being a dual credit or visiting student from
high school?
• Transcripts of your current or previous college or high school coursework are
not required.
• You are not required to pay an application fee.
• You may begin your college education early, saving time and money.
What are the limitations to being a UMKC dual credit or visiting student
from high school?
• You are not eligible for financial aid.
• You are not eligible for academic advising.
• You may register for classes only during open registration (see Registration
Guide). Some classes are not open to visiting students from high school.
• As a dual credit high school student, you will be limited to taking the college
classes offered at your high school.
• Admission as a dual credit or visiting student from high school is for only one
term. If you wish to attend a second or consecutive term, you will need to
complete either a regular application for admission or a dual credit or visiting
student high school application.
• As a dual credit or visiting student from high school, you will acquire a grade
for your class and a UMKC GPA. That GPA is an official record of your
work in the University of Missouri System and will be used to determine
admissibility should you seek regular admission to UMKC or another
University of Missouri school.
• Hours accumulated as a dual credit or visiting student from high school
may or may not count toward a degree at UMKC, depending on the specific
requirements of the degree program you enter.
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