Undergraduate Inquiry Form

Biographical Information

First Name*

Last Name*

Birthdate*

Contact Information

Email Address*

Home Phone

Cell Phone

Mailing Address*

Country
Street
City
Region
Postal Code

Educational Plans

Intended Start Date*

What type of undergraduate degree are you seeking?*

Bachelor Degree

Associate Degree

Graduate Degree

Intended Major*

Are you a Licensed Practical Nurse?

Yes

No

What is your intended course load?

Full-time

Part-time

Educational Background - High School & College/University

Did you/will you earn a High School Diploma or GED Certificate?*

GED

High School Diploma

High School (Search By City)*

Date of Anticipated/Actual High School Graduation*

CEEB Code

Level of Study

Date of anticipated/actual GED completion

GED issuing state

Have you ever attended a college or university?*

Yes

No

Are you a member of Phi Theta Kappa?

Yes

No

Athletics

Do you plan to participate in NCAA Division III Athletics?

Yes

No

Please select your sport of interest:

Additional Information

Have you ever served in any of the US Armed Services?

Yes

No

Are you planning on using VA benefits?

Yes

No

Are you interested in our residential program for single parents?*

Yes

No

The Single Parent Scholar Program provides family-friendly, on-campus housing year-round to single parents and their children (between 20 months and 12 years of age) so the parent can pursue a bachelor’s degree full time. If this does not apply to you, please select 'No' above.

Contact Preferences

Do you grant Wilson College permission to communicate via text message?

Yes

No