Application for
Undergraduate Admission
1401 South U.S. Hwy. 421
Westville, IN 46391-9542
Instructions for applying to Purdue North Central
• Type or print clearly your full, legal name in ink
• Students transferring from another university must submit a $30 transcript evaluation fee.
• Missing or incorrect items will delay processing of your application
• If you have been academically dismissed from any Purdue campus contact PNC Enrollment Services
for readmissions instructions and deadlines.
• You may apply online at www.pnc.edu/admissions/undergrad.html
No Previous College Work
First-time Freshman - If you have
never attended a college, submit this
application and an official high-school
transcript or GED scores. If you graduated from high school less than three
year ago, submit SAT I or ACT scores.
Non-Degree - If you are planning to
take a few courses for credit, but do not
intend to pursue a degree, submit this
application. Non-degree students may
apply no more than 18 semester hours
of work towards an undergraduate
degree at a Purdue campus. Nondegree students are not eligible for
financial aid.
Students with Disabilities – Purdue University North Central is
committed to providing equal access and equal opportunity to
University courses, activities and programs for students with
disabilities. Students with documented disabilities that substantially limit a major life activity, such as learning, walking or
seeing, may qualify for academic adjustments and/or services.
To request information about academic adjustments, auxiliary
aids, or services, please contact the Disability Services Coordinator at (219) 785-5374. Relay Indiana is used for TDD Communications 800-743-3333.
Purdue University North Central is an equal access/equal
opportunity university. No qualified person will be denied
admission or employment, nor will any student or employee be
subjected to discriminatory treatment or be excluded from
participation in any educational program or activity on the basis
of race, religion, color, sex, age, national origin, disability, or
status as a disabled Vietnam era veteran.
revised 8/12
1-219-785-5505
1-800-872-1231(in-state)
AIM: pncadmissions4
email: admissions@pnc.edu
www.pnc.edu/admissions
an equal access/equal opportunity university
Some Previous College Work
Transfer - If you have attended college,
but never attended PNC or another
Purdue campus, submit this application,
an official high school transcript or GED
scores and official transcripts from
all colleges you have attended. If you
hold a bachelor's degree, you do not
need to submit a high school transcript.
There is a one time $30 transcript evaluation fee on transcripts outside of the
Purdue system.
Re-entry - If you previously attended
PNC or another Purdue campus as a
regularly admitted student, submit this
application and official transcripts from
any colleges attended since your last
enrollment at Purdue.
Permanent Regional Campus
Transfer from Purdue - If you are
currently attending another Purdue
campus and want to transfer permanently to PNC, submit this application.
Temporary Regional Campus
Transfer from Purdue - If you are
currently attending another Purdue
campus and want to take classes
temporarily at PNC, submit this
application.
Non-Degree With College Course
Work or "Guest" - If you are planning
to take a few courses for credit, but do
not intend to pursue a degree, submit
this application. You may enroll temporarily at PNC for up to 18 credit hours.
Why We Want To Know
Although reporting your Social Security Number (SSN) to Purdue North Central is not required and your SSN
will not be used as your Purdue student identification number, it is required to receive certain federal tax benefits. Additionally, the SSN is helpful to accurately match your application with other records such as SAT or ACT
scores. Disclosure of your SSN will be restricted to university business processes, such as those required for federal and state reporting as well as institutional purposes. By providing your SSN, you authorize the university
to disclose it to third parties as necessary for these purposes.
Purdue University is committed to assisting all members of the campus community in providing for their own
safety and security. The University prepares an Annual Security Report containing statistics and information relating to campus safety and security policies and programs. All admitted students will receive Purdue University North Central Annual Security Report Notice. The report is available at www.pnc.edu/pd/safety.html, If you
would like a paper copy of the Report, please call 219-785-5220.
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PURDUE NORTH CENTRAL DEGREES
MASTER’S DEGREES
(Requires Graduate Application)
Business Administration
Elementary Education *
BACHELOR’S DEGREES
Behavioral Science (LA)
Psychology
Sociology
Biology (S)
Concentrations in:
Ecology
Microbiology
Pre-Dentistry
Pre-Medicine
Pre-Veterinary Medicine
Business (B)
Concentrations in:
Accounting
Economics
Management
Marketing
Communication (LA)
Computer & Information Technology (ET)
Construction Engineering and
Management Technology (ET)
Early Childhood Education (LA)
Electrical Engineering (ET)
Elementary Education (LA)
Engineering Technology (ET)
Concentrations in:
Electrical & Computer Engineering
Technology
Industrial Engineering Technology
Interdisciplinary Engineering Technology
English (LA)
History (LA)
Human Resources (B)
Liberal Studies (LA)
Concentrations include, but are not limited
to the following:
Behavioral Science
Business
Communications
Math Statistics
Natural Science
Organizational Leadership & Supervision
Mechanical Engineering (ET)
Mechanical Engineering Technology (ET)
Nursing (S)
Nursing - BS
Nursing 2+2 to BS Degree Completion
Organizational Leadership & Supervision (B)
Psychology (LA)
Secondary Education (LA)
Subject tracks in:
Life Sciences
Math
Physical Science
Social Work (LA)
ASSOCIATE DEGREES
Building Construction Management (ET)
Computer & Information Technology (ET)
Electrical Engineering Technology (ET)
Mechanical Engineering Technology (ET)
Organizational Leadership & Supervision (B)
Emphasis in Human Resources
Organizational Leadership & Supervision (B)
CERTIFICATES
Computer & Information Technology (ET)
Human Resources (B)
Mechanical Engineering Technology (ET)
Office Productivity (ET)
Organizational Leadership & Supervision (B)
Process Improvement (ET)
Professional Communication (LA)
Quality Control (ET)
Supervision (online) (B)
* A graduate degree in Education offered by West Lafayette on the Purdue North Central Campus.
TRANSFER PROGRAMS
A student can begin any of the programs below at Purdue North Central. After 1, 2 or 3 years, the student can apply for transfer to complete the degree at another
Purdue campus or another college or university. This is a partial listing of majors/programs. See www.purdue.edu for complete listings.
Aeronautical and Astronautical Engineering
Agribusiness Management
Agricultural and Biological Engineering
Animal Agribusiness
Animal Production
Apparel Design and Technology
Applied Mathematics
Art Education
Art History
Athletic Training
Aviation Technology
Biological and Food Process Engineering
Biomedical Engineering
Chemical Engineering
Chemistry
2
Dietetics
Entomology
Farm Management
Financial Counseling and Planning
Fine Arts
Fisheries and Aquatic Sciences
Food Science
Foods and Nutrition in Business
Forestry
Health and Safety Education
Health Promotion
Horticultural Science
Hospitality and Tourism Management
Interdisciplinary Science
International Agronomy
Landscape Architecture
Mathematics Education
Mathematics/Computer Science
Movement and Sport Science
Natural Resources
Nuclear Engineering
Nutrition, Fitness, and Health
Occupational Health Science
Personal Fitness Training
Physical Education
Radiologic Health Science
Selling and Sales Management
Turf Science
Wildlife
Wood Products Manufacturing Technology
Application for Undergraduate Admission
Missing or incorrect information will delay consideration of your application. Please print clearly.
_____________________________________________________________ ____________________________
Last Name
First
________/________/_________
Middle
Maiden (or other former name)
Official Use Only
__________________________________ ___________
Birth Date (Mo/Day/Yr)
Social Security Number
___________________________________________________________________________________________
Street Address
City
State
(_______) ___________________________________
Zip
___________________________________________
Home Phone
County (if an Indiana Resident)
(_______) ___________________________________
PU ID#
___________________
Date Rec’d
___________________
Eval Fee
___________________
Check
___________________
Proc Int
___________________
Gender
____________________________________________
Cell Phone
Student’s Email
1. Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Race:
American Indian/Alaskan Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
(Check the appropriate boxes. State and federal laws pertaining to civil rights require the university to report ethnic data.)
2. Your place of employment _______________________________________________________________
Full-time
Part-time
3. If out of school for more than 12 months, describe your activities since your last enrollment (employment, homemaking, military service, etc.)
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
4. Country of citizenship:
5. If non-U.S. citizen:
International
United States
Other (specify country) _____________________________________________________
Permanent Resident Number __________________________ (Attach a copy of Green Card or I-94 form)
Asylee or Refugee
None of the Above
By selecting “None of the Above” as my citizenship type, I understand
that I am not eligible for Indiana resident tuition.
6. Residence: Which state (or foreign country) do you claim as your legal residence? ____________________ _______________________
State
Dates you have lived in Indiana:
Birth to present
Foreign Country
Indiana resident (m/y) ________ to (m/y) ________
Never resided in Indiana
7. Parent or Guardian (if under 21) ___________________________________________________________
Last
First
Middle
_____________________________________________________________________________
Number/Street
City
State
(______)______________________
Zip
8. Have either of your parents earned a four-year college degree?
yes
Parent Phone
no
For research purposes only
9. Are you a veteran?
Yes, (attach photocopy of DD 214 )
No
10. Alumni Affiliation: Check any that have attended or are attending Purdue University.
Father
11. If admitted, when will you begin at PNC?
Summer I (May)
12. Have you attended another Purdue Campus?
Fall (August)
Yes
Spring (January)
No
Mother
Brother
Sister
Summer II (June) Year 20___
If yes, specify last campus attended ___________________________
13. Intended major _______________________________________________________________________________________________
Admissions Office
(219) 785-5455 • (219) 462-4197 • (800) 872-1231 (in-state) • Relay Indiana (800) 743-3333
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14. High school information _______________________________________________________________________________________
City
Name
Year of graduation ________________ GED completion date (if applicable)
_______________________
Indicate all date(s) you took or will take the SAT and/or ACT ___________________
____________________ ___________________
SAT (month/year)
15. Are you on academic probation with any university/college?
yes
State
ACT (month/year)
Neither
no Have you been dropped from any university/college?
yes
no
16. List all colleges/universities you have attended. See cover page for transcripts required for your admission status. Place an asterisk (*)
next to any institution in which you are currently enrolled. Failure to provide official transcripts will disqualify your application.
Transcripts for another Purdue Campus do not need to be submitted.
_____________________________ _____________________ _____________ _____________ ____________________________
Name of college/university
City and State
From (Month/Year) to
(Month/Year)
Degree and year received (if applicable)
_____________________________ _____________________ _____________ _____________ ____________________________
Name of college/university
City and State
From (Month/Year) to
(Month/Year)
Degree and year received (if applicable)
_____________________________ _____________________ _____________ _____________ ____________________________
Name of college/university
City and State
From (Month/Year) to
(Month/Year)
Degree and year received (if applicable)
17. My intention is to (check all that apply)
Be a full-time student
Complete my degree at PNC
Complete my degree at another Purdue campus
Complete my degree outside the Purdue system
Be a part-time student
Take 1 or more courses, but do not plan to earn a degree
Pursue a degree program at PNC
Take one or two courses at PNC
18. If Non-Degree my intention is to (check all that apply)
Pursue a certificate at PNC
Renew teaching license
19. I certify that all the information provided is accurate and true. I understand that falsified information may result in denial of admission and/or termination of
enrollment at Purdue University North Central. I affirm, under the penalties for perjury, that the following representations, including information related to my
citizenship status and/or presence in the United States, are true. I authorize Purdue University North Central to report my admission status and academic program
to my high school counselor for the purpose of curriculum development and improvement of instruction. I authorize secondary and post-secondary schools I have
attended to release information needed by Purdue University North Central to process and verify my application. I authorize Purdue University North Central's
Division of Financial Aid to release, as it deems appropriate, information on my academic program (including grades) and the amount of any financial award I may
receive to agencies, institutions, and others involved in providing funds for my education. I agree to abide by the policies, rules and regulations of PNC.
_____________________________________________________ ___________
Signature of Applicant
Date
A complete application will ensure the processing of your application as quickly as possible. All records submitted become the property of Purdue University.
For current high school students only (to be completed by the high school guidance counselor)
Please complete the information below and append any information that might help PNC make an informed admission decision. Attach an official copy of
the applicant’s H.S. transcript, including courses in progress and SAT or ACT scores and mail to: PNC Admissions, 1401 S. U.S. Hwy. 421, Westville, IN 46391
Student Name ______________________________
Rank in Class ______/______ after
Test scores
SAT:
ACT:
six
Date _________
Date _________
Indiana residents only
Please do not leave blank
seven
Accreditation: High School is
eight semesters
CR _____________
E _____________
SR _____________
Applicant: Pursuing CORE 40 Diploma
yes
Pursuing Academic Honors Diploma
Twenty-first Century Scholar
yes
accredited
not accredited by a state educational agency
school does not rank students
G.P.A. _______ Scale _______
M _____________
M _____________
C _____________
W _____________
R _____________
EW ____________
no Passed GQE/ISTEP
yes
no Passed ECA
yes
no
yes
no Pursuing Technical Honors Diploma
yes
no
no
Senior year course in progress: (if school is on a block schedule, please list courses in all blocks for senior year)
Seventh Semester (Block 1/Block 2)
Eighth Semester (Block 3/Block 4)
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
Comments _____________________________________________________________________________________________________________________________
____________________________________________
___________________________________________
Counselor’s Signature
____________________________________________
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High School
Counselor’s Name (Please Print)
____ ____ ____ ____ ____ ____
CEEB Code Number
____________
Date
(____) _____________________
Guidance office phone number