NYC Studio
The Fashion School
Kent State University
TRANSIENT ADMISSION APPLICATION
TO BE COMPLETED BY UNDERGRADUATE TRANSIENT STUDENT (Please print in ink or type.)
____________________________________________________ Social Security No.___________________
Last Name
First Name
Middle Initial
Gender ___ F ___ M Former/Maiden Name_______________________ Date of Birth _______________________
____________________________________________________________________________________
Home Address (Street or P.O. Box)
____________________________________________________________________________________
City
State
Zip
County
____________________________________________________________________________________
E-Mail Address
Phone
Ethnic information is used for reporting purposes only. Select one or more as appropriate:
____ Caucasian American (White) ____ American Indian or Alaskan Native ____ Hispanic or Latino
____ African American (Black)
____ Asian American or Pacific Islander ____ Non U.S. Citizen
Are you a U.S. citizen? ___Yes ___ No If no, visa type? _____________________________________
Are you a permanent resident of the United States? _____ Yes _____ No
If permanent resident, card number and date granted: ________________________________________
Have you previously enrolled in classes at any campus of Kent State University? _____ Yes _____ No
If yes, have you ever been dismissed (____Yes ____ No) and reinstated (_____ Yes _____ No)?
I plan to attend Kent State University: Year_________ Summer Fall Spring
____________________________________________________________________________________
Signature of Applicant
Date
TO BE COMPLETED BY COLLEGE/UNIVERSITY YOU ARE NOW ATTENDING
This is to certify that____________________________________________________________________
Name of Student
is in good standing and has a 2.50 GPA or above and is eligible for immediate re-enrollment at
______________________________________________________________________
Name of College or University
City
State
Zip
This student has permission to enroll as a transient student at Kent State University.
______________________________________________________________________
Signature of College/University Representative
Title
Date
(Dean, Registrar, or other authorized academic official)
Mail completed and signed form to: Young Kim
NYC Studio Director
Kent State University – NYC Studio
th
315 West 39 Street #402
New York, NY 10018
4/12/13