RE-ENTRY STUDENT APPLICATION
* Indicates required field.

Personal Information

Term of Entry:*

Fall 20082009201020112012 or Spring 20092010201120122013

First Name:*

Middle Name:

Last Name:*

Preferred Name/Nickname:

Social Security Number:*

Gender:*

Male Female

Date of Birth:* (mm-dd-yyyy)

Marital Status:

Permanent Address:*

City:*

State:*

Zip:*

Home Telephone:* (area code first)

Cell Telephone:

Employer:

Work Telephone:

Email Address:

Are you a U.S. citizen?*

Yes No

If not, are you a permanent U.S. resident?

Yes No

Country of Citizenship:

Race: (optional)

Religion: (optional)

Name of Hometown Newspaper:

Are you a spouse or dependent of a UE employee?*

Yes  No
If yes, what is his or her name and in what department is he or she employed?
Name:   Department: 
Please contact the Office of Human Resources to obtain a tuition remission application and brochure.

School/College Information

Select Your Intended Major:   Accounting Archaeology Ceramics Graphic Design Painting Pre-art Therapy Sculpture Art - Undecided Visual Communication Art History Athletic Training Biology Economics Finance Global Business Management Management Information Systems Marketing Biochemistry Chemistry Business Administration Classical Studies Clinical Laboratory Science Cognitive Science Advertising and Public Relations Journalism Multimedia Production Organizational Communication Computer Science Elementary Education Senior/Junior High & Middle School Education Art Education English Education French Education German Education Mathematics Education Physical Education Science Education Social Studies Education Spanish Education Special Education Education - Undecided Civil Engineering Computer Engineering Electrical Engineering Mechanical Engineering Engineering - Undecided Creative Writing Literature Writing Environmental Administration Environmental Science Exercise Science French German Spanish Health Services Administration History International Studies Internet Technology Legal Studies Actuarial Science Application Mathmatics Pre-doctoral Music Education Music Management Music Performance Music Therapy Music - Undecided Neuroscience Nursing Philosophy Physical Therapist Assistant (associate degree) Physical Therapy (doctoral degree) PT/Athletic Training PT/Biology PT/Interdisciplinary Studies PT/Exercise Science Physics Political Science Pre-Dentistry Pre-Law Pre-Medicine Pre-Optometry Pre-Veterinary Medicine Psychology Biblical Studies Theological Studies Anthropology Criminal Justice General Sociology Gerontology Preprofessional Social Work Sport Communication Sport Management Acting Design and Technology Stage Management Theatre Generalist Theatre Education Theatre Management Undeclared

High School Name:*

High School Type:*

High School City:*

High School State:*

Year of Graduation:*

High School Extracurricular and Academic Achievements:

If you are currently enrolled at another university:

College/University Name:

Your Campus Telephone:

Your Campus Address:

Your Campus City:

Your Campus State:

Your Campus Zip:

How long do you expect to be at this location? (approximate date)

List the names, locations and dates of attendence of all post-secondary schools you have attended, including the University of Evansville. Please be sure to include the number of hours attempted and any degree(s) earned. *

College Extracurricular and Academic Achievements:

Anticipated Classification

Housing Plans

Your name when enrolled at UE:

Year(s) you attended UE:

Reason(s) for your departure:

Please indicate chronologically where you have been and what you have been doing since leaving UE:

Scholarship Information

The following information will be shared with the Office of Financial Aid. Check all of the following for which you wish to be considered. If you qualify for more than one of these awards, you will receive the one of highest value. It is possible for scholarships to be reinstated for re-entry students depending upon how long you have been away from the University. The scholarships listed below are for full-time students only.

Are you an Indiana Twenty-first Century Scholar?

Yes No

University of Evansville Academic Scholarship - You must have a minimum 3.0/4.0 cumulative GPA for college level work to be considered for the Academic Scholarship. The scholarship ranges from $6,500 to $9,000 each academic year. Auditions and portfolio presentations are required for students majoring in art, music or theatre. Talent may influence the amount of the merit scholarship. If you have not scheduled an audition or portfolio presentation, please contact the Office of Admission for assistance.

Phi Theta Kappa Scholarship (honor society for community colleges and two-year institutions.) - This award is valued at $10,000 per year for members who are in good standing. Please mail a photocopy of your Phi Theta Kappa membership certificate to the Office of Admission.

University of Evansville Legacy Award - This scholarship is for children, grandchildren and great-grandchildren of UE graduates. It is worth $6,500 per year. Eligible applicants should complete the following information about the UE graduate:

Name:     Relationship:     Graduation Year:

United Methodist Scholarship - This award is worth $6,000 per year for students who attend and are confirmed members of a United Methodist Church. Eligible applicants should complete the following information:

Name of Church:     Church Minister:

Telephone Number:     Church Address:

City:     State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ---- Puerto Rico Virgin Islands     Zip Code:

Additional sources of assistance such as grants, loans, and work-study may be available. To apply you must file the Free Application for Federal Student Aid (FAFSA) or the Renewal FAFSA form. The FAFSA is available through any college office of financial aid or online at www.fafsa.ed.gov.

Yes, I will be filing the FAFSA or Renewal FAFSA Form.

Family Information

You do not need to fill out this section if you meet one or more of the following:

• Born before January 1, 1985 (for enrollment in the 2008-2009 academic year), or before January 1, 1986 (for enrollment in the 2009-2010 academic year).
• You are a graduate student.
• You are married.
• You have legal dependents other than a spouse.
• You are an orphan or ward of the court.
• You are a veteran of the U.S. Armed Forces.
• You are determined to be independent for financial aid purposes by the University of Evansville Office of Financial Aid.

Please provide information about the people with whom you currently reside:

Parent A:

Name:

Daytime Telephone Number:

Employer:

Occupation:

College(s) Attended:

Parent B:

Name:

Daytime Telephone Number:

Employer:

Occupation:

College(s) Attended:

Parent C: Biological parent at another address:

Father Mother Other

Name:

Daytime Telephone Number:

Employer:

Occupation:

College(s) Attended:

Please list all other people living in your household. Please include the name, age, relationship to you, the school or college he/she currently attends or has attended, and the current or highest grade/level achieved:

University of Evansville Academic Honor Code and Statement of Certification

Have you ever been convicted of a felony?*   Yes No
If yes, please explain in a letter and send it to the Office of Admission.

Academic integrity has always been a hallmark of the University of Evansville. The Academic Honor Code enables both students and faculty to pursue their scholarly endeavors in an environment of academic freedom. It is an environment that our students both expect and demand. Matriculation at the University of Evansville is contingent upon subscribing to the values of the following honor code:

"I understand that any work which I submit for course credit will imply that I have adhered to this Academic Honor Code: I will neither give nor receive unauthorized aid nor will I tolerate an environment which condones the use of unauthorized aid."

In addition, you hereby certify that the information given on this application is accurate to the best of your knowledge. You understand that all transcripts as well as other admission documents become the property of the University of Evansville and you waive your right to access these documents. You grant permission for your high school and college(s) to furnish all academic information requested by the UE Office of Admission.

Yes, I agree to the terms above.*

Our goal is to make our application as straightforward and concise as possible, while collecting sufficient information to make an appropriate admission and scholarship decision. After we receive your completed application and all required documents, you will be notified about our admission and scholarship decision.

The University of Evansville operates under a non-discriminatory policy with regard to race, color, age, religion, disability, sex and national origin.