Full Name*

Other Names on Transcripts

Date of Birth*

Country of Citizenship*

If you are not a US citizen but you live in the US, please indicate your VISA status or permanent resident number.

Social Security Number*

Mother's Maiden Name

Current Mailing Address*

City*State*Postal Code*

Home/Primary Telephone (Please do not use any dashes.)*

Cell Phone Number (Please do not use any dashes.)

Email address:*

Have you ever been convicted of a felony or any sexual, narcotics, or drug offense? If yes, please submit an explanation to admission@usw.edu.*

Male Female

Ethnic Background: *

Is your ethnic background Hispanic or Latino?

If you answered yes, please select one:

Religious Preference *

What is your expected entrance term? *

I will be a *
Degree Seeking Student Non-Degree Seeking Student

Which graduate program are you applying for? *

Where and when did you earn your Bachelor's degree from? Please list the location of this institution. *

Do you already have graduate credits?*

If you have already have graduate credits, please list where the credits are from.

Have you ever been dismissed from a higher education institution? If yes, please submit an explanation to admission@usw.edu.*
Yes No

How did you learn about University of the Southwest? *

*If other, please specify: