UNIVERSITY HONORS APPLICATION
(Continuing NIU Student)
NAME Last, First Initial
Z-ID# Z_____
BIRTH DATE mm/dd/year
PERMANENT ADDRESS
Street City, State Zip
CAMPUS/LOCAL ADDRESS
Street City, State Zip
PHONE NUMBER
Primary Phone
☐ Cell ☐ Home
☐ Cell
Other Phone (optional)
☐ Home
NAME(S) OF ☐PARENT(S), ☐GUARDIAN(S) OR ☐SPOUSE (please select and enter one category only)
Enter Name(s)
EMAIL
Enter Email
GENDER
☐ Male ☐ Female ☐ Transgender ☐ I do not wish to identify
GRADUATION DATE Semester/Year
High School Rank # out of #
HIGH SCHOOL Name City, State
COLLEGE(S) OR UNIVERSITY(IES) ATTENDED:
TOTAL HOURS: ___
CUMULATIVE GPA: ___
1. Name of College or University
2. Name of College or University
3. Name of College or University
JOINING NIU HONORS FOR: Semester, Year
EXPECTED DEPARTMENTAL MAJOR(S) AT NIU Major Department(s)
EXPECTED DEPARTMENTAL MINOR(S) AT NIU Major Department(s)
Please check the category that best describes your racial/ethnic background (optional).
Are you Hispanic, Latino, or Spanish Origin?
☐Yes, I am Hispanic or Latino/Latina
☐No, not of Hispanic, Latino/Latina
Hispanic or Latino/Latina means a person of Cuban, Mexican, Puerto Rican, South or Central American, or other
Spanish culture or origin, regardless of race.
Please select the option which best describes your race (optional). You may check more than one box.
☐American Indian or Alaska Native
A person having origins in any of the original peoples
of North and South America (including Central
America), and who maintains a tribal affiliation or
community attachment
☐Asian
A person having origins in any of the original
peoples of the Far East, Southeast Asia, or the
Indian subcontinent including, for example,
Cambodia, China, India, Japan, Korea, Malaysia,
Pakistan, the Philippine Islands, Thailand and
Vietnam.
☐Black or African-American
A person having origins in any of the Black racial
groups of Africa
☐Native Hawaiian or Pacific Islander
A person having origins in any of the original
peoples of Hawaii, Guam, Samoa, or other Pacific
Islands
☐White/Caucasian/Non-Hispanic
A person having origins in any of the original peoples
of Europe, the Middle East or North Africa
☐Other (please specify)
Click here to enter text.
Please write a brief statement below describing your academic and cultural interests and why you wish to join the
Honors Program. Please attach and submit your statement with your application.
ELECTRONIC SIGNATURE: First and Last Name
Date: mm/dd/year
☐ By checking this box I agree that all statements provided are true and any falsifying information could result in removal
from the University Honors Program.
NOTE: The Honors House in New Hall – East is reserved for members of the University Honors Program. If you wish to
be considered for residence, please contact the Assistant Director for Programming of the University Honors
Program.
Please complete and submit
application to University Honors by
email at honors@niu.edu, mail, or fax
at 815-753-9507.
University Honors Program
Attn: Associate Vice Provost
Northern Illinois University
DeKalb, IL 60115
(815) 753-0694