Honors Application Packet
Heritage University
3240 Fort Road
Toppenish, WA 98948
509.865.0440 Phone
509.865.8659 Fax
888.272.6190 Toll Free
www.heritage.edu
2015-16 Cohort Year
Spring 2015
Heritage University Honors Program Criteria and Application Requirements
To be considered for the 2015-2016 Honors Program Cohort, you must be admitted and to
Heritage University, and have demonstrated academic excellence through a combination of
earned grade point average, completion of advanced placement courses, and/or higher than
average placement on academic assessments such as the COMPASS and SAT.
HU Honors Program applicants must complete and submit the following information to the
Honors Program committee no later than May 8, 2015:
 Heritage University Honors Program Application (May substitute Soar or Act Six
application support materials if previously completed, in which case complete the yellow
highlighted sections below)
 A personal goals statement (minimum of two pages, double spaced, and typed; however,
if Soar or Act Six essays are a total of two pages, they may be substituted as long as they
address personal and academic goals.)
 One written teacher or counselor reference letter that can attest to your academic ability
and your previous commitment to exemplary academic performance. (Please include
name, title, phone number and email of reference, and date that written reference can be
expected, if the information is not included in this application.)
Send your completed application packet to: HU Honors Program
Attn: Tita Medina
Heritage University
3240 Fort Road
Toppenish, WA 98948
Students invited to interview for the Honors Program will receive a letter no later than June 1,
2015. Planned date for interviews and Heritage University Honors program is Wednesday, June
17, 2015.
Spring 2015
Heritage University Honors Program Application
(May Substitute Soar Application Form or Act Six Application Form: Complete Highlighted Areas Below)
PERSONAL INFORMATION
Last Name:
First Name:
Middle Initial:
Student ID#:
Phone #:
Message #:
Address:
City:
State:
Zip:
Email:
I have applied for admissions to Heritage University:
I am entering as a:
 Yes
 No
 New Student
 Continuing Student
 Transferring Student
Date:
Last date attended:
(List colleges you have attended below, including Heritage if you are returning student)
In the upcoming Fall Semester I will be enrolling as:
 Freshman
Date:
I have taken the COMPASS college placement test:
 Yes
 No
Date:
I have taken the SAT college placement exam:
 Yes
 No
Date:
Score:
(not required for application)
EDUCATIONAL BACKGROUND
High School:
Location:
GPA:
Degree Earned:
College:
Location:
GPA:
Total Credits:
College:
Location:
GPA:
Total Credits:
List any advance placement courses taken:
(use the back of this page if necessary)
Spring 2015
Grade:
Grade:
Grade:
Grade:
Grade:
ADDITIONAL INFORMATION
Honors and Awards Received:
Indicate any awards/scholarships/honors received from your school, community or any other supporting organizations.
Extracurricular Activities:
Please list activities you have been involved with outside the classroom, whether at school, work, or in the community.
Volunteer Experience/Community Service:
Please list activities you have been involved with outside the classroom, whether at school, work, or in the community.
Personal Goals Statement:
On a separate sheet of paper, please answer the following questions:
1.
2.
In the past year, what accomplishments are you most proud of, and why?
What are your long and short term goals?
Your personal goals statement should include your name centered at the top of the page. Responses should be limited to two full
pages, doubled spaced, typed, and using Times New Roman or Arial 12 pt. font.
Personal References
Identify one individual that can attest to your character and disposition as a student. References should also be able to
speak to your academic ability. A written reference included with this application is preferred, but we will also accept
name, title, phone number, and email address for your reference.
Heritage University Honors Program
3240 Fort Road
Toppenish, WA 98948
509.865.0440 Phone
509.865.8659 Fax
Spring 2015