Application for Undergraduate Admission

University of Michigan-Flint

Application for Undergraduate Admission

Apply online for free at umflint.edu/admissions/apply

OPTIONAL

GENERAL INFORMATION (Please type or PRINT LEGIBLY with BLACK INK.)

Last Name (Legal)

First Name (Legal)

Suffix

Middle (Full)

Previous last name(s), if any

Birth date (mm/dd/yy)

Social Security Number

Current Mailing Address (Number and Street)

City

State

Gender m Female Zip Code

m Male

Permanent Mailing Address (if different)

City

State

Zip Code

Mobile Phone

(

)

-

Home Phone

(

)

-

Email Address

Citizenship

m U.S. Citizen m Permanent Resident/Green Card m Noncitizen Country

Race/Ethnicity: Information is collected for state and federal reporting requirements, as well as for statistical purposes. It is not used in the admission process and will have no bearing on your admission status.

Please indicate whether you consider yourself to be Hispanic or Latino. m No, not Hispanic or Latino m Yes, Hispanic or Latino

In addition, select one or more of the following racial categories to describe yourself: m American Indian or Alaska Native m Asian m Black or African American m Native Hawaiian or Other Pacific Islander

Native Language m White

Are you a veteran? Are you serving or have you served in the U.S. Military (including National Guard and Reserve Components)? m Yes m No

Are you eligible for veteran educational benefits? m Yes m No

Are you the spouse/dependent of a veteran? m Yes m No

ENROLLMENT INFORMATION

Applying as: m Freshman m Transfer m Non-Degree Anticipated date of enrollment (Enter year) m September-Fall 20______ m January-Winter 20______ m May-Spring 20______ m July-Summer 20______ Academic Interest/Major (see list below): m Undecided

ACADEMIC INTEREST

Actuarial Mathematics Africana Studies Anthropology Applied Science Art - Studio Art History & Criticism Biochemistry Biology - General Biology - Human Biology Biology - Molecular & Biotechnology Biology - Wildlife Biology Business - Accounting Business - Finance Business - General Business - International Business Business - Management Business - Marketing Business - Organizational Behavior & Human Resources Chemistry Communication Computer Information Systems

Computer Science Criminal Justice Dance Economics Education (Elementary) Education (Secondary) - Art Education Education (Secondary) - English Education (Secondary) - French Education (Secondary) - History Education (Secondary) - Integrated Science Education (Secondary) - Mathematics Education (Secondary) - Music Education Education (Secondary) - Social Studies Education (Secondary) - Spanish Education (Secondary) - Speech Energy and Sustainable Systems Engineering - General Engineering - Mechanical English - Linguistics Specialization English - Literature Specialization English - Writing Specialization Environmental Science & Planning

French French & International Studies French & Linguistics Health Care Administration Health Sciences History Interdisciplinary Studies Mathematics Medical Technology / Clinical Laboratory Science Music - General Music - Performance Nursing (Pre) Nursing (RN to BSN) Philosophy - General Philosophy of Neuroethics Physics Political Science Pre-Dental Pre-Law Pre-Medicine Pre-Pharmacy

Pre-Physical Therapy Pre-Physician Assistant Pre-Veterinary Psychology - Applied Psychology Psychology - General Psychology - Research Psychology Public Administration Public Health Radiation Therapy (Pre) Social Sciences, Joint Programs Social Work (Pre) Sociology Spanish Spanish & International Studies Spanish & Linguistics Theatre Theatre Design & Technology Theatre Performance Undecided Visual Communication

Other: _____________________________

Note: Majors as listed in the 2014-15 Catalog. Please see the website for the most up-to-date information or for majors available in previous Catalogs.

Last updated: 11-25-14

ACADEMIC HISTORY

List the most recent high school and ALL colleges and universities you have attended. Official copies of transcripts must be mailed directly to the Office of Admissions from all institutions attended. Failure to acknowledge attendance at another institution may result in immediate dismissal. List any additional institutions on a separate page.

High School/College/University

City, State

Attended from (mm/yy)

Attended to (mm/yy)

Type of Degree Earned/

Graduation Date

For office use only

IN-STATE TUITION GUIDELINES

Are you a Michigan resident? m Yes, since (month/year):

m No

If you have lived outside the state of Michigan in the last three years, please list the most recent state (or nation if outside the US) and approximate dates you lived there.

If any of the following circumstances listed below apply, you are required to file an Application for In-State Tuition if you wish to be considered for in-state tuition assessment.

? You live outside the State of Michigan for any purpose. ? You attended or graduated from a college outside the State of Michigan. ? You lived or worked outside the State of Michigan at any time within the last three years. ? You are not a U.S. citizen. ? Your spouse, partner, or parent is in Michigan as a nonresident student, medical resident, fellow or for military assignment or other temporary employment. ? You are 24 years of age or younger and a parent lives outside the State of Michigan. ? You are 24 years of age or younger and attended or graduated from a high school outside the state of Michigan. ? You attended or graduated from an out-of-state high school and have been involved in educational pursuits for the majority of time since high school graduation. ? You attended any University of Michigan campus (Ann Arbor, Dearborn, or Flint) as a nonresident.

Questions pertaining to your residency status can be answered by staff in the Residency Classification Office, University of Michigan Office of the Registrar, 1210 LSA Building, 500 South State Street, Ann Arbor, MI 48109-1382, phone (734) 764-1400. To apply for in-state tuition classification visit ro.umich.edu/resreg.php.

SUPPORTING MATERIALS

Have you ever been expelled, suspended, or placed on probation by any secondary school or college you attended for academic dishonesty or because of an offense that harmed or had the potential to harm others? Have you ever been convicted of a criminal offense other than a minor traffic violation, or been found to be delinquent by a juvenile court, or are there such charges currently pending against you at this time?

If you answered yes to either of the questions above, you must include a separate, detailed statement of explanation.

m Yes m Yes

m No m No

APPLICATION FEE

A $30 nonrefundable fee is due with your Freshman or Transfer paper application. Checks may be made payable to the University of Michigan-Flint. For international applicants that are unable to send a check, please send an International Postal Money Order, in U.S. dollars, which is commonly obtained at your local post office.

PERSONAL INFORMATION

I certify that all the information given in this application is true and complete, including a report of all college work attempted or completed. I understand that the University of Michigan may verify any information I have provided. Falsification or omission of information and credentials may result in the withdrawal of my application or in the revocation of admission, financial award, or registration. I understand all credentials and documents I present become the property of the University of Michigan. I authorize the Regents of the University of Michigan, on behalf of the University of Michigan-Flint, to secure high school academic transcripts and ACT/SAT scores on my behalf (freshman applicants only). I authorize the release of my contact information, on file with the university to alumni clubs that may consider me for scholarships. Signature (required) Date

Include on a separate sheet(s) any special information (personal essay, letters of recommendation) you would like the Office of Admissions to consider. This is not necessary for admission, but important for scholarship consideration.

Office of Admissions ? 303 E. Kearsley St. ? 245 University Pavilion ? Flint, MI 48502-1950 ? (810) 762-3300 ? Fax: (810) 762-3272 ? umflint.edu/admissions ? admissions@umflint.edu

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