SPECIAL STUDENT APPLICATION
* Indicates required field.

Personal Information

Please indicate the category which best represents your status:*

Term of Entry:*

Fall or Spring

First Name:*

Middle Name:

Last Name:*

Maiden Name:

Preferred Name/Nickname:

Social Security Number:*

Gender:*

Male Female

Date of Birth:* (mm-dd-yyyy)

Marital Status:

Permanent Address:*

City:*

State:*

Zip:*

Home Telephone:* (area code first)

Cell Telephone:

Employer:

Work Telephone:

E-mail Address:

Are you a U.S. citizen?*

Yes No

If not, are you a permanent U.S. resident?

Yes No

Country of Citizenship:

Do you consider yourself to be Hispanic or Latino? (optional)
Yes No
Please select one or more of the following race categories to describe yourself:
(optional)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White or Caucasian

Religious Affiliation: (optional)

Name of Hometown Newspaper:

Are you a spouse or dependent of a UE employee?*

Yes  No
If yes, what is his or her name and in what department is he or she employed?
Name:   Department: 
Please contact the Office of Human Resources to obtain a tuition remission application and brochure.

List the Evansville course number(s) and course title(s) of the class(es) you wish to enroll in:*

University of Evansville Academic Honor Code and Statement of Certification

Have you ever been dismissed from a high school, college or university for disciplinary reasons?*   Yes No
If yes, please explain in a letter and send it to the Office of Admission.

Have you ever been convicted of a felony?*   Yes No
If yes, please explain in a letter and send it to the Office of Admission.

Academic integrity has always been a hallmark of the University of Evansville. The Academic Honor Code enables both students and faculty to pursue their scholarly endeavors in an environment of academic freedom. It is an environment that our students both expect and demand. Matriculation at the University of Evansville is contingent upon subscribing to the values of the following honor code:

"I understand that any work which I submit for course credit will imply that I have adhered to this Academic Honor Code: I will neither give nor receive unauthorized aid nor will I tolerate an environment which condones the use of unauthorized aid."

In addition, you hereby certify that the information given on this application is accurate to the best of your knowledge. You understand that all transcripts as well as other admission documents become the property of the University of Evansville and you waive your right to access these documents. You grant permission for your high school and college(s) to furnish all academic information requested by the UE Office of Admission.

"I acknowledge that if I provide false information to the University concerning my application, the institution has the right to revoke or deny my admission."

Yes, I agree to the terms above.*

 

Our goal is to make our application as straightforward and concise as possible, while collecting sufficient information to make an appropriate admission and scholarship decision. After we receive your completed application and all required documents, you will be notified about our admission and scholarship decision.

The University of Evansville operates under a non-discriminatory policy with regard to race, color, age, religion, disability, sex, and national origin.