5
Academic & Career Interest
Indicate any field of interest, intended major, or career or professional goals you are considering
_________________________________________________________________________________________________
Are you a transfer applicant inducted into Phi Theta Kappa?
Yes No
Will you have earned an Associate of Arts or Associate of Science degree from a North Carolina Community
College prior to enrollment?
Yes No
Academic Information
List ALL high schools, colleges and universities you have ever enrolled in, regardless of credit earned, including
the institution you are currently attending, if any.
Name City/State/Country
Dates Attended
From To
Type of degree or
diploma
(earned or expected)
High School is public private home school
When did you graduate from high school or receive your high school general equivalency diploma? ______/___
(month/year)
List all courses in which you are currently enrolled. If not currently enrolled, check here and answer the
question that follows the course title section.
Course Title (also list course number if college level) Unit of Credit
If you are not currently enrolled in an educational program, please provide information about how you have
spent your time since leaving school. (next page)
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
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