Undergraduate Admissions Application

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Biographical Information
An * will mark any required fields.
First Name *Middle Name Last Name *

Preferred NameMaiden Name

Social Security Number *Confirm SSN *Date of Birth (MM/DD/YYYY) *

Are you a U.S. Citizen? *If no, of what country are you a citizen?
Yes No

Do you hold Permanent Resident status (valid I-551) for the U.S.?If yes, provide the date on which your Permanent Resident card was issued (MM/DD/YYYY)
N/A Yes No

Alien Identification Number

Have you ever been convicted of a felony? If yes, please send an explanation to admissions@usw.edu. *

Contact Information
Street Address Line 1 *Street Address Line 2

City *State *Zip/Postal Code *

Primary Phone Number *Alternate Phone Number

Preferred Email Address *Confirm Email Address *

Parent or Legal Guardian
If you are under the age of 18, please list the contact information for your parent or legal guardian.
First NameLast Name

Primary Phone NumberEmail Address

Emergency Contact Information
Nature of Relationship to Applicant *

First Name *Last Name *

Phone Number *Alternate Phone Number *

Demographic Information
Gender *

Are you of Hispanic or Latin American Descent?

Please select the racial category or categories with which you most closely identify. Check as many as apply.
American Indian or Alaska Native Asian Black or African American
Native Hawaiian or Other Pacific Islander White

Are you a first generation student? (Neither parent completed college) *

Student Intentions
You are applying as a: *If you selected other, please explain

Please select how you will be attending. *

Intended Start Year: *Intended Start Term: *

Intended Major: *Will you be seeking teacher licensure? *

Will you be attending USW as a student-athlete? *

If yes, please select the sport for which you are being recruited.

Do you intend to apply for or use financial aid? *

Educational Background
Have you previously applied to USW? *

High School Name *High School City *High School State *

High School Graduation Date: *

Do you have a GED?

Have you taken the ACT or SAT? Please have official scores sent from the testing agency to USW. *

Previous Colleges or Universities
Please list all previous colleges or universities you have attended or are attending, including dual credit. Please include name of institution, city, state and hours attempted. Failure to list all institutions will be considered an intentional omission and may lead to forced withdrawal. Please send an official transcript from all schools listed.

Are you currently on academic probation or suspension from the last college or university attended? *

Have you ever been dismissed from a college or university? If yes, please send an explanation to admissions@usw.edu. *