2014 Wichita State Undergraduate Admission Application
Application for New Undergraduate Students Please read attached instructions. For U.S. citizens and permanent resident applicants only. Admission cannot be determined until admission application, $30 application fee, test scores and transcripts are received. Please complete the application using black ink. Please print neatly or type. For office use Section 1: Applicant Information 1 2 Social Security number (optional) Date of birth mm/dd/yyyy 3 Your gender Male Female 4 Legal name Last First Middle 5 Other names and nicknames used on records (including maiden name) 6 Current residence Mailing address City, State Zip/Postal Code County Area code and home phone number Cell number Email address where you’d like to receive WSU updates and enrollment information 7 Permanent residence Mailing address City, State Zip/Postal Code County 8 Place of birth City State Country Please respond to the following questions related to your ethnicity and race. (Optional) 10 Yes No 9 Ethnicity: Are you Hispanic or Latino? What is your race? 11 Are you a U.S. citizen? If yes, skip to section 2 Yes No American Indian or Alaska Native Native Hawaiian or other Pacific Islander Asian White Black or African-American 12 Are you a permanent resident, asylee or refugee in the U.S.? Yes No Enclose a photocopy of the front and back of your permanent resident, asylee or refugee card. If yes, date your card was issued: Card number mm/dd/yyyy 13 If you are not a citizen of the U.S., please list: Country of birth Country of citizenship 14 Do you currently reside in the U.S. on a non-immigrant visa? Yes No If yes, contact International Admissions at (316) 978-3232 or online at wichita.edu/international. Section 2: Parent or Guardian Information 15 Parent or guardian (complete only if you are under 21) Name Phone Email Parent Guardian Mailing address City, State Zip/Postal Code County Section 3: Kansas Residency Information (All questions left blank will be considered evidence of a non-Kansas resident.) 16 Are you a resident of the state of Kansas? If Yes No “yes,” when did you begin living continuously in Kansas? 17 If you relocated to Kansas, from where did you move? mm/dd/yyyy If “no,” and you previously lived in Kansas, please state the period of time you lived in Kansas: to mm/yyyy mm/yyyy 18 Last year, did anyone claim you as a dependent for income tax purposes? Yes No 19 Are either of your parents or guardians a Kansas resident? If yes, how long? Yes No visit wichita.edu/admissions for more information or to apply online.