A-1 Undergraduate Application for Admission Please attach $65.00 application fee and complete all three pages of the application. This application is intended for all applicant types who plan to take courses on campus or off campus. All students are encouraged to complete an application online. Go to apply.wcu.edu for additional applications and instructions. Your failure to provide complete, accurate and truthful information on this application will be grounds to deny or withdraw your admission or dismiss you after enrollment. Contact Information 1. _____________________________________________________________________________________________________________________ Last name Suffix (Jr., III, etc.} First Middle Former last name, if any _____________________________________________________________________________________________________________________ Preferred name or nickname 2. _____________________________________________________________________________________________________________________ Mailing address City _____________________________________________________________________________________________________________________ State Zip County 3. Telephone (______)__________________________________ Country Cell Phone (______) __________________________________________ 4. a. Have you been a resident of North Carolina for the past 12 months? (required) o Yes o No b. Please list address(es) at which you have maintained a permanent (legal) residence during the preceding 18 months (please show month, day, year): ________________________________________________________________________________ From ______________To_ _______________ Street/Route/P.O. box City State Zip Dates of residence ________________________________________________________________________________ From ______________To_ _______________ Street/Route/P.O. box City State Zip Dates of residence 5. _____________________________________________________________________________________________________________________ Employer Nature of work Date from Date to Telephone 6. E-mail address _ ________________________________________________________________________________________________________ Emergency Contact 7. Name___________________________________________________________________ Relationship to you______________________________ 8. _____________________________________________________________________________________________________________________ Street/Route/P.O. Box City State Zip Applicant Information 9. Gender o Male o Female 10.Date of birth_ ______________________________ Place of birth_ ______________________________________________________________ mm dd yyyy 11.Social Security number _______ - ______- __________ (Providing this information is voluntary. It is used only for record-keeping purposes.) 12.Are you a U.S. Citizen? o Yes o No If not a U.S. citizen, country of citizenship _ __________________________________________________ 13.If not a U.S. citizen, Visa type, number and expiration date _______________________________________________________________________ 14.a. Are you of Hispanic or Latino descent? o Yes o No b. If not of Hispanic or Latino descent, then please check all that apply: o White, not of Hispanic origin o Black, not of Hispanic origin o Hispanic American o American Indian/Alaskan Native o Asian or Pacific Islander o International/other o Multiracial 15. I am interested in spiritual activities at WCU and my religious preference is_________________________________________________________ Gender/Ethnicity are requested for federal/state reports. Religious preference is optional to help us provide information about your interests. Western Carolina University does not practice or condone discrimination against applicants on the basis of ethnicity, color, national origin, religion, gender, age, sexual orientation or disability. A-2 High School Information 16.List all high schools attended for any length of time, whether or not you have completed a term (list most recent first). High School Attended 17.Have you ever taken the SAT or ACT? City State Zip CodeGraduation Date (month/year) o Yes o No If yes, give date___________________________________________________________ College Information 18.List all colleges attended in the order of attendance with the most recent listed first. This must include any institution at which you registered for classes (even if a withdrawal was granted) and those which you will attend prior to enrollment at WCU. Dual enrollment work completed while in high school should also be listed here. Failure to list prior college course work could result in denial of admission or dismissal. College Attended City StateDate AttendedDegree Received From To Entrance Information 19.Entering term and year: ccc c-c c 80=August (fall) 50=May (summer) 10=January (spring) (i.e., 2009 - 80 = fall 2009) 20.Entrance status: o Freshman o Transfer o Returning o Early College o Dual Enrollment o Distance Learning o Military (All other applicants apply online at apply.wcu.edu) 21.Attendance: o Full-time o Part-time 22.Intended academic program (i.e., Z –AS – ANTH – FANT = forensic anthropology) Refer to the program chart on page A-4 to enter the appropriate code number that pertains to your area(s) of interest. You will have opportunities throughout the application, advising, and registration processes to make changes. Primary Secondary Z- c c-ccc c-c c c c Z- c c - c c c c - c c c c 23.a. Have you previously applied for admission to WCU? o Yes o No If yes, please indicate when_ _____________________________________ b. Are you are first-generation college student? o Yes o No c. Are you in the Teacher Cadet Program but not being certified at Western Carolina University? o Yes o No Military Information 24.Have you been in active military service in the past 24 months? o Yes o No Branch of service______________________________________ 25.Are you currently a military dependent or were you a military dependent within the past 24 months? o Yes o No 26.Name of military person____________________________________________ Relationship to you_______________________________________ 27.Permanent duty station_____________________________________________ State_ _________________________________________________ 28.Are you a veteran? o Yes o No 29.Dates of military service: Begin date_______________________ Anticipated/actual end date___________________________________________ A-3 Required Questions 30.Your “yes” answer to one or more of the following questions will not necessarily preclude your admittance. However, your failure to provide complete, accurate and truthful information will be grounds to deny or withdraw your admission or to dismiss you after enrollment. For the purpose of the following questions, “crime” or “criminal charge” refers to any crime other than a traffic-related misdemeanor or an infraction. You must, however, include alcohol or drug offenses whether or not they are traffic related. 1. Have you been convicted of a crime? o Yes o No 2. Have you entered a plea of guilty, a plea of no contest, a plea of nolo contendere, or an Alford plea; or have you received a deferred prosecution or prayer for judgment continued to a criminal charge? o Yes o No 3. Have you otherwise accepted responsibility for the commission of a crime? o Yes o No 4. Do you have any criminal charges pending against you? o Yes o No 5. Have you ever been expelled, dismissed, suspended, placed on probation or otherwise subject to any disciplinary sanction by any school, college or university? o Yes o No 6. If you have ever served in the military, did you receive any type of discharge other than an honorable discharge? o Yes o No o Currently Serving o Never Served 7. Are you eligible to continue at your current or last college attended? o Yes o No If you answered “yes” to any of the questions above, please write a detailed explanation of the circumstances: You must promptly notify the Admission Office in writing of any criminal charge, any disposition of a criminal charge or any school, college or university disciplinary action against you, or any type of military discharge other than an honorable discharge that occurs at any time after you submit this application. Your failure to do so will be grounds to deny or withdraw your admission or to dismiss you after enrollment. I understand that the university encourages its students, faculty and staff to display the following traits of citizenship: behavior characterized by honesty, integrity and responsibility; service to others; awareness of and sensitivity to the concerns of diverse people and cultures; and commitment to stewardship of the natural and cultural environment. By completing and submitting this application, I agree to the policies and regulations of Western Carolina University. To the best of my knowledge, the information I have given is true and accurate. I understand my failure to provide complete, accurate, and truthful information on this application will be grounds for refusal of admission, cancellation of admission or dismissal from the university. ________________________________________________________________________________________________________________________ Applicant Signature (required) Date A-4 Western Carolina University program chart for admission application Program CodesProgram Codes Academically Gifted Licensure Distance Accounting Anthropology Anthropology (Forensic) Art Athletic Training Biology Birth-Kindergarten - Distance Business Administration & Law Chemistry Chemistry (Biotechnology)* Chemistry (Environmental)* Coaching Communication Communication (Broadcasting)* Communication (Public Relations)* Communication Sciences & Disorders BS Computer Information Systems Computer Science Construction Management Criminal Justice Criminal Justice - Distance Electrical & Computer Engineering Technology Electrical Engineering Elementary Education Distance UG Elementary Education Emergency & Disaster Management Emergency & Disaster Management - Distance Emergency Medical Care Emergency Medical Care - Distance Emergency Medical Care (Science)* Engineering Sales & Distribution Certificate Engineering Technology Engineering Technology - Distance English (Literature)* English (Motion Picture Studies)* English (Professional Writing)* English BA English BSED Entrepreneurship - BS Entrepreneurship - BSBA Environmental Health Environmental Science Finance Finance (Financial Planning)* Forensic Science Geology Geology (Environmental Hydrology)* Geology (Solid Earth)* German Gerontology Certificate Health Information Administration History Hospitality Tourism & Management Interior Design Management EAAIG2 BS-ACCT AS-ANTH AS-ANTH-FANT FP-ART HH-ATTR AS-BIOL EA-BK2 BS-BALW AS-CHEM AS-CHEM-BT AS-CHEM-EC EA-UNEA-COCH AS-COMM AS-CM-BC AS-CM-PR HH-CODI BS-CIS AS-CS KS-CM HH-CJ HH-CJ2 KS-ECET KS-EE EA-ELED2 EA-ELED HH-EDM HH-EDM2 HH-EMC HH-EMC2 HH-SCE KS-ETSD KS-ET KS-ET2 AS-ENGL-LIT AS-ENGL-MPS AS-ENGL-PW AS-ENGL EA-ENGL BS-BS-ETP BS-ETP HH-ENVH AS-ES BS-FIN BS-FIN-FNP AS-FSC AS-GEOL AS-GEOL-ENVL AS-GEOL-SE AS-GERM HH-GRTG HH-HIA AS-HIST BS-HTM FP-IDES BS-MGT BS-MKT AS-MATH EA-MATH EA-LASS EA-MALA EA-MASC EA-MASS EA-SCLA EA-SCSS FP-MPT FP-MUS FP-MUS-CE FP-MUS-MIO FP-MGP EA-MUED-GMU EA-MUED-IMU FP-MT AS-NRM AS-NRM-FRS AS-NRM-LSA AS-NRM-SWR HH-NURC2 HH-NUR-C5 HH-NTDT EA-PRM EA-PRM-CRR EA-PRM-CR EA-PRM-OLI AS-PHIL EA-PE AS-POLS HH-PNUR GN-PRDN GN-PRLW GN-PRMD GN-PROT GN-PRPH GN-PRPT GN-PRVM EA-PSY HH-RETH HH-SOWK AS-SOC AS-SPAN EA-SPNE EA-SEGE BS-SPMG BS-SPMG-AAD BS-SPMG-ESF FP-THEA FP-THEA-ACT FP-THEA-DSN FP-THEA-TPD GN-UDCL GN-UDCL2 Marketing Mathematics Mathematics in Education Middle Grade: Language Arts & Social Science Middle Grade: Math & Language Arts Middle Grade: Math & Science Middle Grade: Math & Social Science Middle Grade: Science & Lang Arts Middle Grade: Science & Social Science Motion Picture & Television BFA Music Music (Commercial & Electronic Music)* Music (Music Industry)* Music (Performance)* Music Education - General Music Music Education - Instrumental Musical Theatre Natural Resource Conservation Management Natural Resource Conservation Mgt (Forest Resources)* Natural Resource Conservation Mgt (Landscape Analysis)* Natural Resource Conservation Mgt (Soil & Water Conservation)* Nursing - Capstone - Distance Nursing RN to MS(N) - Distance Nutrition/Dietetics Parks & Recreation Management Parks & Recreation Mgt (Commercial & Resort Recreation)* Parks & Recreation Mgt (Community Recreation)* Parks & Recreation Mgt (Outdoor Leadership & Instruction)* Philosophy Physical Education Political Science Pre-Nursing Pre-Dentistry Pre-Law Pre-Medicine Pre-Optometry Pre-Pharmacy Pre-Physical Therapy Pre-Veterinary Medicine Psychology Recreational Therapy Social Work Sociology Spanish Spanish Education Special Education Sport Management Sport Management (Athletic Administration)* Sport Management (Exercise Science)* Theatre Theatre (Acting)* Theatre (Design)* Theatre (Technical Production)* Undeclared/Undecided Undeclared/Undecided - Distance *Concentration Office of Admission | 1 University Drive | Cullowhee, NC 28723 | (828) 227-7317 or toll free (877) WCU-4YOU | admiss@wcu.edu | www.wcu.edu 5,000 copies of this public document were printed at a cost of $1,300.00, or $0.26 per copy. University Publications | 09-074