Application for New Undergraduate Students
Please complete the application using black ink. Please print neatly or type.
For office use
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.
Section 1: Applicant Information 1
2 Social Security number (optional) Date of birth
Your gender Male
4 Legal name Last First Middle
Other names and nicknames used on records (including maiden name)
Current residence Mailing address
Area code and home phone number
Email address where you’d like to receive WSU updates and enrollment information
Permanent residence Mailing address
Place of birth City
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?
American Indian or Alaska Native
If yes, skip to section 2
12 Are you a permanent resident, asylee or refugee in the U.S.? No
13 If you are not a citizen of the U.S., please list: Country of birth
Black or African-American
If yes, date your card was issued: Card number
Enclose a photocopy of the front and back of your permanent resident, asylee or refugee card.
Native Hawaiian or other Pacific Islander
14 Do you currently reside in the U.S. on a non-immigrant visa?
If yes, contact International Admissions at (316) 978-3232 or online at wichita.edu/international.
Country of citizenship
Section 2: Parent or Guardian Information 15 Parent or guardian (complete only if you are under 21) Name
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
18 Last year, did anyone claim you as a dependent for income tax purposes?
If “no,” and you previously lived in Kansas, please state the period of time you lived in Kansas: to mm/yyyy
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.