Fillable COASTAL CAROLINA UNIVERSITY Application for Undergraduate Admission Readmission (Coastal Carolina University)

Fill Online, Printable, Fillable, Blank COASTAL CAROLINA UNIVERSITY Application for Undergraduate Admission Readmission (Coastal Carolina University) Form

Use Fill to complete blank online COASTAL CAROLINA UNIVERSITY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

COASTAL CAROLINA UNIVERSITY Application for Undergraduate Admission Readmission (Coastal Carolina University)

On average this form takes 25 minutes to complete

The COASTAL CAROLINA UNIVERSITY Application for Undergraduate Admission Readmission (Coastal Carolina University) form is 5 pages long and contains:

  • 2 signatures
  • 0 check-boxes
  • 90 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Coastal Carolina University

BROWSE COASTAL CAROLINA UNIVERSITY FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
For additional information, contact:
Coastal Carolina University
Offi ce of Admissions
P.O. Box 261954 • Conway, SC 29528-6054
843-349-2170 or 1-800-277-7000 • 843-349-2127 fax
admissions@coastal.edu • coastal.edu
Application for Undergraduate Admission
Readmission and Nondegree Students
Nondegree Admissions
A nonrefundable application fee of $45 is required with this application for all
nondegree applicants. Applicants who wish to attend the University for one
semester or for up to 18 credit hours may be approved to do so upon submitting
this application. The Offi ce of Admissions reserves the right to determine the proper
category of admission. Applications must be approved prior to the fi rst day of the
semester. Enrollment will not be permitted after classes are in session. Students in
a nondegree status are not eligible for fi nancial aid.
Students will be required to complete a new Application for Undergraduate
Admission (Readmission and Nondegree Students) and submit the required
processing fee if they are not continuously enrolled during the regular fall and
spring semesters (excludes summer terms).
• Transient Students are students who wish to take courses at Coastal Carolina
University while regularly enrolled in another “home” institution. Students are
responsible for securing approval from the Academic Dean or University Registrar
at their “home” institutions. Transient students are eligible to apply for on-campus
housing during summer sessions only. For more information, contact the Offi ce of
University Housing, 843-349-6400.
• Pre-College High School Students may be eligible to begin college studies
on a course availability basis while concurrently enrolled in high school. Pre-college
applicants must provide a high school transcript with a minimum B+ average through
the junior year and acceptable PSAT, SAT or ACT scores, along with a letter of
recommendation from a high school counselor or principal.
• Adult Learners are applicants who seek to enroll in courses for personal or
professional enhancement and who are at least 22 years old. At the completion of
18 credit hours, it is required that the student apply for degree-seeking status by
submitting a new Application for Undergraduate Admission, accompanied by offi cial
transcripts from all previously attended institutions.
NOTE: Senior citizens (age 60 or older) who are legal residents of South Carolina and
who are not employed full time may be eligible to attend classe
s on a space available
basis without the payment of tuition (excludes required course fees), provided the
applicant meets the admission requirements and other standards of the University.
Senior citizens may register for classes under the free tuition provision the day prior to
the fi rst day of class for the current term. The senior citizen must complete either the
Nondegree or Degree-Seeking Undergraduate Application depending on the status of
enrollment that is desired. In addition, the Free Tuition Application for Senior Citizens
must be completed and submitted to the Offi ce of Admissions.
Readmission of Former Coastal
Carolina University Students
To be considered for readmission,
undergraduate students who are
returning to the University after missing
a major term (fall or spring semester)
must complete this application, submit
the nonrefundable application fee of
$15 and provide offi cial transcripts for
all institutions attended after leaving
the University. Summer sessions do
not count as a major semester in this
instance. Readmission to the University
and to the program in which the student
was previously enrolled is not automatic.
Students who are seeking readmission
after the fi rst suspension must complete
this application and submit it to the
Offi ce of Admissions. Students who are
seeking readmission after the second
suspension must seek readmission
through the Academic Suspension
Petitions Committee. Students who
desire to return after a second or
indefi nite suspension must complete
the Academic Suspension Appeal form
and return it to the Offi ce of the Dean for
the student’s respective college. Should
permission to return to the University be
granted, then the student must complete
and submit this application along with
the nonrefundable application fee.
Students who have attended other
colleges since leaving the University are
required to submit offi cial transcripts.
Earning a Degree at
Coastal Carolina University
Students who wish to earn a degree
from Coastal Carolina University must
complete the Undergraduate Application
for Degree-Seeking Students and
submit the required application fee and
transcripts. The application can
be completed online at:
coastal.edu/admissions/apply.html.
7/15
COASTAL CAROLINA
UNIVERSITY
Offi ce of Admissions – Residency
Coastal Carolina University • P.O. Box 261954 • Conway, SC 29528-6054 • 843-349-2170 or 1-800-277-7000 • 843-349-2127 FAX
scresidency@coastal.edu • coastal.edu/admissions/residency
Coastal Carolina University (CCU) does not discriminate on the basis of race, color, religion, sex, national origin, age, genetic information, mental or physical disability, or status as a
disabled or Vietnam-era veteran in its admissions policies, programs, activities or employment practices. For more information relating to discrimination, please contact the CCU Title IX
Coordinator/EEO Investigator; Coastal Carolina University, Kearns Hall 104B, Conway, SC; Title IX email titleix@coastal.edu; office phone 843-349-2382; Title IX cell phone 843-333-6229;
EEO email eeo@coastal.edu; or the U.S. Dept. of Education Office for Civil Rights at http://www2.ed.gov/ocr.
Thank you for your interest in attending Coastal Carolina University!
Once your application is complete (including submission of offi cial transcripts), you should hear from us regarding your
admission status within three weeks. Again, thank you for choosing Coastal Carolina University.
If you are admitted to the University and become a student here, any information on the application may be made public, with the exception of your Social Security number or
Alien Registration number. If you wish to keep the information private, you must advise the University in writing. Forms are available in the Offi ce of the Registrar.
ITEMIZED INSTRUCTIONS
ITEMIZED INSTRUCTIONS
Item 3 SOCIAL SECURITY NUMBER
Item 3 SOCIAL SECURITY NUMBER
Please double check your Social Security number. An incorrect number will delay processing of your application. This number will be
used
solely for the purpose of identification and ensuring accuracy in the processing of this application.
Federal law recognizes the student Social Security number (SSN) as personally identifiable information under the Family Education Rights and Privacy
Act of 1974 (FERPA). However, the law permits Coastal Carolina University to request and use this information in compliance with state and federal
guidelines. You are not required to provide an SSN to be considered for admission, but you are strongly encouraged to do so, if you have one.
Providing an SSN will assist with matching records to your application, such as transcripts and test scores.
NOTE: An SSN is required to apply for financial aid. If you plan to apply for financial aid, you are encouraged to provide your SSN on your admissions
application to assist with financial aid processing later. Providing your accurate Social Security number will also help with citizenship verification.
Item 16 MAJOR
Item 16 MAJOR
(for readmission of former Coastal Carolina University students only)
All degree-seeking students must declare a major. Indicate one of the following choices on the application, Question 16. Please enter the code given.
BUSINESS ADMINISTRATION
• Accounting – ACCP
• Certifi ed Public Accountant – CPA
•
Certifi ed Management Accountant/
Certifi
ed Financial Manager – CMAFA
• Economics – ECONP
• Finance – FINP
•
Financial Management – FMGT
•
Financial Services – FSRV
• Wealth Management – WMGT
• Hospitality, Resort and Tourism Management - HRTMP
• Management – MGTP
• Entrepreneurial Management – EM
• General Management – GEN
• Human Resources Management – HRM
• International Management – IM
• Operations and Technology Management – OTM
• Organizational Leadership – OL
• Marketing – MKTP
NOTE: A specialization in PGA Golf Management is
available for all majors in the Wall College of Business –
PGMP
EDUCATION
• Early Childhood Education (PreK-3) – ECEDP
• Elementary Education (2-6) – ELEDP
• Middle Level Education (5-8) – MGEDP
(must choose two)
• Math – MATH
• Science – SCIE
• Social Studies – SSTD
• English – ENGL
• Physical Education (K-12) – PHED
• Special Education-Learning Disabilities (PreK-12)
–
SPEDP
Coastal Carolina University off ers a graduate level Master
of Arts in Teaching (M.A.T.) program in the areas of:
Art English Mathematics
Music Science Social Studies
If you are interested in becoming a licensed teacher
in any of these areas, you should fi rst earn an
undergraduate degree in that area of concentration.
In your junior and senior years
,
you will be allowed
to take three courses which can apply toward this degree.
For more information, contact the Offi ce of Graduate
Studies at 843-349-2394.
HUMANITIES and FINE ARTS
• Art Studio – ARTS
• Communication – COMM
• Communication Studies – CSTD
• Health Studies – HCOM
• Interactive Journalism – IJOUR
•
Public Relations/Integrated Communication –
PRCOM
• English – ENGL
• Graphic Design – GDES
• History – HIST
• Intelligence and National Security Studies –
INTEL
• Music – MUSP *
• Musical Theatre – MUTHP **
• Philosophy – PHIL
• Political Science – PSCI
• Domestic Politics – DPOL
• Global Politics – GPOL
• Theatre Arts – TARTP **
• Acting – ACT
• Design and Technology – DTCH
• Physical Theatre – PHTH
*All students who desire to pursue a bachelor of
arts (B.A.) degree in music must successfully
complete an audition. For more information, go to
coastal.edu/music.
**All students who desire to pursue a bachelor of
fi ne arts (B.F.A.) degree in theatre arts or musical
theatre must successfully complete an audition.
For more information, go to coastal.edu/theatre.
SCIENCE
• Biochemistry – BCHEM
• Biology – BIOL
•
Cellular, Molecular Biology and Genetics –
CMGH
• Ecology, Evolution and Conservation Biology –
EECO
• Integrative Biology – IBIO
• Chemistry – CHEM
• Computer Science – CSCI
• Dual Degree Engineering (3+2 Dual Degree
Program with Clemson University)
You must select one of the following
Coastal Carolina University/Clemson dual majors:
• Biology/Engineering – BIO-E
• Chemistry/Engineering – CHM-E
• Computer Science/Engineering – CSC-E
• Applied Physics/Engineering – PHY-E
•
Exercise and Sport Science – EXSS
• Health Administration – HADM
(only for transfer applicants,
online degree completion program)
• Health Promotion – HLPR
• Information Systems – INFSY
• Information Technology - IT
• Marine Science – MSCIP
• Mathematics (applied) – MATHA
• Nursing - NUR
(only for transfer applicants with an RN License)
• Physics (applied) – PHYSA
• General – GEN
• Environmental Physics – ENVPH
• Engineering Physics – ENGPH
• Psychology – PSYC
• Recreation and Sport Man age ment – RSM
• Recreation Man age ment – RMGT
• Sport Man age ment – SMGT
• Sociology – SOC
• Generalist – GEN
• Criminology – CRIM
• Health and Aging – HLAG
• Social Justice – SJUS
INTERDISCIPLINARY STUDIES
• Interdisciplinary Studies – INTSP
(only for transfer applicants)
UNDECLARED
• Undeclared – UNUG
PRE-PROFESSIONAL MAJORS
• Pre-Allied Health/Biology – AH
• Pre-Dental/Biology – DT
• Pre-Law/Political Science – LW
• Pre-Medical/Biology – MD
• Pre-Pharmacy/Biology – PH
• Pre-Physical Therapy/Biology – PT
• Pre-Veterinary/Biology – VT
Term ___________________________________
INDEPENDENT - RESIDENCY INFORMATION FORM
Applicants who claim South Carolina residence for tuition and fee purposes must complete this form in its entirety. Additional information may
be requested per SC Law 59-112. South Carolina residency requirements may be found online at che.sc.gov.
Student Information
Student Name _
______
_______
____________________________________________________________
Social Security Number or CCU ID ______________________
Age _________ Date of birth ____________________________ City and State of birth _________________________________________________________________
Residency Information (Student Information)
You have indicated that you are an Independent Person, enter your information below. An independent student is defi ned as one who will
provide more than half of his/her support for the 12 months immediately preceding his/her enrollment or re-enrollment and will NOT be
claimed as a dependent or exemption on the income tax returns of a parent, guardian or spouse.
Citizenship:
U.S. citizen
Permanent Resident Alien
Not a U.S. Citizen or Permanent Resident Alien
How long have you resided in South Carolina? Years _________________ Months _________________
Address (Street, City, State, Zip code) ___________________________________________________________________________________________________________
Did you claim yourself for tax purposes for the prior year?
Yes
No If not, who claimed you? _________________________________________
Your marital status:
Single/never married
Married
Divorced/separated
Widowed
Re-married
Current Residence:
Rent/lease
Own
With Parents
Campus residence
Driver’s License: State ______________ Date Issued __________________
New (fi rst issued)
Renewed Expiration date ____________________
Vehicle Registration: State ______________ Date Issued __________________
New (fi rst issued)
Renewed Expiration date _________________
Do Not Own a Vehicle
If you have relocated to South Carolina, what was their previous state of residence? _______________________________________
Employment Status:
Full-time
Part-time
Unemployed
Retired
Disabled
Employer Name __________________________________________________________________________ Telephone _____________________________________
Employer Address ________________________________________________________________________________________________________________________
Employer Dates: From
(mm/dd/yy) _________________________________________ To (mm/dd/yy) _________________________________________
If your South Carolina resident status is based upon active military assignment to the state, please submit a copy of your current orders to the
Offi ce of Admissions.
Branch of Service:
USAF
USA
USN
USMC
USCG Home of record on L.E.S. _________________________________
I certify that all information provided is accurate and complete. I further understand that falsifi cation or failure to provide the correct information
may lead to the disqualifi cation of my application for admission to Coastal Carolina University.
Signature of parent/guardian/spouse ____________________________________________________________________ Date ____________________
Offi ce of Admissions • Residency • scresidency@coastal.edu • Fax 843.349.2127
Offi ce of Admissions
Residency
Coastal Carolina University
P.O. Box 261954 • Conway, SC 29528-6054
www.coastal.edu/admissions/residency.html
Name and Relationship
(mm/dd/yy) (mm/dd/yy)
(mm/dd/yy) (mm/dd/yy)
APPLICANT: If you provide more than half of your support, complete this form with your information.
Undergraduate Admission Application
Readmission and Nondegree
__TRANSIENT ($45) __PRE-COLLEGE ($45) __ADULT LEARNER ($45) __SENIOR CITIZEN ($45)
__AUDIT ($45) __TEACHER CADET ($45)
2. I WISH TO BEGIN MY STUDIES AT COASTAL CAROLINA UNIVERSITY. Check one, list year (yy) in the blank.
__ Fall Semester
___________
__
Spring Semester
___________
__
Maymester
___________
__ Summer I Session
___________
__Summer II Session
____________
3. SOCIAL SECURITY NUMBER ___________________ – ____________ – ___________________ (REQUIRED FOR U.S. CITIZENS OR PERMANENT RESIDENTS APPLYING FOR FINANCIAL
AID.)
4. NAME LAST ________________________________________________________________________ FIRST _______________________________________________________________________
MIDDLE ___________________________________________________________________________ SUFFIX (JR., III, IV) __________________________
4 a.
PREFERRED NAME
_______________________________________________________________________________________________________________________________________________________
5. MAIDEN OR FORMER NAME USED AT OTHER COLLEGES
__________________________________________________________________________________________________________________________
6. HOME/PERMANENT ADDRESS
P.O. BOX, RFD, STREET _______________________________________________________________________________________________________________________________________________ CITY
__________________________________________________________________________________________ STATE ____________________ ZIP CODE ______________________________ COUNTY
_______________________________________
________________________________________________
IS YOUR MAILING ADDRESS THE SAME AS YOUR PERMANENT ADDRESS? __ YES __ NO
MAILING ADDRESS IF DIFFERENT FROM PERMANENT/HOME ADDRESS
P.O. BOX, RFD, STREET _________________________________________________________________________________________________________________________________________
CITY ______________________________________________________________________________________ STATE ___________________ ZIP CODE ______________________________
COUNTY
_______________________________________
____________________________________________
7. HOME TELEPHONE ( _______________ ) __________________________________________________ 8. CELL TELEPHONE ( _______________ ) ____________________________________________
__ I give permission to Coastal Carolina University to send text messages to my cell phone number. Message and data rates and charges from you carrier may apply.
For complete terms and conditions email admissions2@coastal.edu.
EMAIL ADDRESS
_______________________________________________________________________________________________________________________________________________________
9. I AM AN INTERNATIONAL STUDENT. __YES __NO
If you selected “Yes”, please stop working on this application and complete our International Undergraduate Application instead.
You can find the online version of the International Undergraduate Application at coastal.edu/admissions/apply.You
will also find a link to print a paper version of the International Undergraduate Application.
COUNTRY OF BIRTH
_______________________________________
________________________
COUNTRY OF CITIZENSHIP ________________________________________
_____________
I AM A PERMANENT RESIDENT OF THE UNITED STATES. __YES __NO ALIEN REGISTRATION NUMBER ________________________________________
_________
(include a copy of Green Card)
10. DATE OF BIRTH (mm/dd/yy) ___________________________________________________
_________
11. GENDER __MALE __FEMALE
12. MILITARY VETERAN/ACTIVE MILITARY
ARE YOU CURRENTLY OR HAVE YOU EVER BEEN A MEMBER OF THE U.S. ARMED FORCES? __YES __ NO
If YES, please check one of the following: ___ Active duty ___Active reserve ___Reserve component ___Veteran
ARE YOU THE SPOUSE OR A DEPENDENT OF A FULL-TIME MEMBER OF THE U.S. ARMED FORCES? ___ YES (SPOUSE) ___YES (DEPENDENT) ___ NO
ARE YOU SEEKING READMISSION TO THE UNIVERSITY AFTER HAVING BEEN CALLED UP TO ACTIVE MILITARY SERVICE THROUGH THE RESERVES OR DRAFTED BEFORE
THE END OF YOUR LAST SEMESTER? ___ YES ___ NO
13. ETHNIC ORIGIN / RACE
I AM HISPANIC OR LATINO. ___ YES ___ NO
WHAT IS YOUR RACE? Regardless of your answer to the previous question, please mark one or more races to indicate what you consider yourself to be.
__ AMERICAN INDIAN OR ALASKA NATIVE __ ASIAN __BLACK OR AFRICAN AMERICAN __ NATIVE HAWAIIAN OR PACIFIC ISLANDER __WHITE
A nonrefundable application fee is required with this application.
1. PLEASE CHECK ONE: __READMISSION ($15), LAST TERM YOU ATTENDED COASTAL CAROLINA UNIVERSITY ______________________________ (SEMESTER AND YEAR)
COASTAL CAROLINA
UNIVERSITY
Term ___________________________________
DEPENDENT - RESIDENCY INFORMATION FORM
Applicants who claim South Carolina residence for tuition and fee purposes must complete this form in its entirety. Additional information may
be requested per SC Law 59-112. South Carolina residency requirements may be found online at che.sc.gov.
Student Information
Student Name _
______
_______
____________________________________________________________
Social Security Number or CCU ID ______________________
Age _________ Date of birth ____________________________ City and State of birth _________________________________________________________________
Parent/Guardian/Spouse Residency Information
You have indicated that you are a current High School Student or a Dependent of a parent or guardian; please enter your parent/guardian/spouse
information below. A dependent student is defi ned as one who will receive more than half of his/her support for the 12 months immediately
preceding his/her enrollment or re-enrollment from a parent, guardian or spouse and will be claimed as a dependent or exemption on that
individual’s income tax returns.
With whom do you reside?
Self
Both parents
Father
Mother
Other ________________________________________
Who claims you for federal income tax purposes?
Self
Both parents
Father
Mother
Other __________________
Parents marital status:
Single/never married
Married
Divorced/separated
Widowed
Re-married
If parents are divorced or separated, who is the custodial parent?
Not applicable
Father
Mother
Shared custody
Name of Parent/Guardian/Spouse?
_
______
_______
___________________________________________________________
_
______
_______
____________________________________________________________
Citizenship:
U.S. citizen
Permanent Resident Alien
Not a U.S. Citizen or Permanent Resident Alien
How long has parent/guardian/spouse resided in South Carolina? Years _________________ Months _________________
Address
(Street, City, State, Zip code) ___________________________________________________________________________________________________________
Parent/Guardian/Spouse – All questions must be answered.
State ID Number _
______
_______
____________________________________________________________
Driver’s License: State ______________ Date Issued ______________
New (fi rst issued)
Renewed Expiration date ___________________
Vehicle Registration: State ______________ Date Issued ______________
New (fi rst issued)
Renewed Expiration date ________________
Do Not Own a Vehicle
If Parent/Guardian/Spouse has relocated to South Carolina, what was their previous state of residence? _______________________________________
Employment Status:
Full-time
Part-time
Unemployed
Retired
Disabled
Employer Name __________________________________________________________________________ Telephone ___________________________________
Employer Address ______________________________________________________________________________________________________________________
Employer Dates: From
(mm/dd/yy) _________________________________________ To (mm/dd/yy) _________________________________________
Branch of Service:
USAF
USA
USN
USMC
USCG Home of record on L.E.S. _________________________________
If your South Carolina resident status is based on active military assignment to the state, please submit a copy of your current orders to the
Offi ce of Admissions.
I certify that all information provided is accurate and complete. I further understand that falsifi cation or failure to provide the correct information
may lead to the disqualifi cation of my application for admission to Coastal Carolina University.
Signature of parent/guardian/spouse ____________________________________________________________________ Date ____________________
Offi ce of Admissions • Residency • scresidency@coastal.edu • Fax 843.349.2127
Offi ce of Admissions
Residency Coastal Carolina University
P.O. Box 261954 • Conway, SC 29528-6054
www.coastal.edu/admissions/residency.html
First Name Last Name Relationship
(mm/dd/yy) (mm/dd/yy)
(mm/dd/yy) (mm/dd/yy)
APPLICANT: If a parent, guardian or spouse provides half of your support, complete this form with your parent’s/guardian’s/spouse’s information.
14. FAMILY CONTACT INFORMATION (CHECK RELATIONSHIP TO YOU) __PARENT __SPOUSE
__
GUARDIAN OTHER ________________________________________
NAME LAST ________________________________________________________________________ FIRST
MIDDLE ___________________________________________________________________________ SUFFIX (JR., III, IV) __________________________
HOME/PERMANENT ADDRESS • P.O. BOX, RFD, STREET _
CITY _____________________________________________________________________________ STATE _______________ ZIP CODE ____________________ ZIP + FOUR _
HOME TELEPHONE
( _______________ ) _____________________________________________
WORK TELEPHONE
( ______________ )
CELL TELEPHONE
( _______________ )
EMAIL ADDRESS
15. I PLAN TO ATTEND CLASSES
__Full time __Part time
16. MAJOR _________________________________ Specialization, if applicable ____________________________________ . (For readmission of former Coastal Carolina University students only.)
17. DO YOU CLAIM RESIDENCY IN SOUTH CAROLINA FOR PURPOSES OF IN-STATE TUITION? __Yes __No If YES, you must complete one of the residency forms on the back of this
application. Complete the Dependent Residency Information Form if you RECEIVE more than half our your support from a parent, guardian or spouse.
Complete the Independent Residency Information Form if you PROVIDE more than half of your support and you will NOT be claimed as a dependent or exemption on the
income tax return of a parent, guardian or spouse.
If all questions are not answered completely, you will be considered an OUT-OF-STATE student for tuition and fee purposes.
ADADEMIC HISTORY
18. HIGH SCHOOL FROM WHICH YOU WILL GRADUATE OR GRADUATED: (for Pre-College High School Students only)
____________________________________________________________________________________ ___________ __________________________ _________________ to _________________
Name of high school State CEEB HS Code Years attended (yyyy to yyyy)
19. COLLEGES ATTENDED: Have you attended any college, either full time or part time, since graduation or taken any college-level courses while in high school?
If yes, please list below all colleges attended, current or most recent first, and ask the institution(s) to forward an official transcript of your work directly to the Office of Admissions,
Coastal Carolina University.
__________________________________________________________________________________ ____________ ________________ ______________________ _____________________
Name of school (full name) State Credits earned Date entered (mm/yy) Date leaving (mm/yy)
__________________________________________________________________________________ ____________ ________________ ______________________ _____________________
Name of school (full name) State Credits earned Date entered (mm/yy) Date leaving (mm/yy)
__________________________________________________________________________________ ____________ ________________ ______________________ _____________________
Name of school (full name) State Credits earned Date entered (mm/yy) Date leaving (mm/yy)
Have you earned an Associate of Arts or an Associate of Science degree?
Yes No
20. NON-ACADEMIC ADMISSION REVIEW
All applicants are required to respond to a series of non-academic admission review questions on the admission application. Responses to these questions are initially reviewed by
the Office of Admissions and Merit Awards. Some cases are referred to the non-academic admission review committee for further review. This non-academic review process supports
the University’s goal of maintaining a safe learning community. Failure to submit complete responses and/or falsification of responses may result in revocation of the admission decision or
dismissal of the student if false information or incomplete responses are discovered after enrollment. Any incident resulting in any change to a non-academic admission review question
subsequent to the application must be immediately reported by the applicant, in writing, to the Office of Admissions and Merit Awards. Failure to do so may result in the revocation of the
admission decision or dismissal of the applicant after enrollment. In addition, registered sex offenders are not allowed to enroll in classes or participate in campus activities. Failure to
disclose registration at any time shall result in immediate dismissal.
The University reserves the right to place conditions on the admission of any student. In the event such action is taken, the conditions will be clearly explained in the letter of acceptance.
If
you answer “yes” to questions 1-9 below, we may request that you provide additional documentation to complete your admission application. A separate request for this information will be
mailed to you after the initial review of your answers to the non-academic review questions.
Have you been adjudicated, processed, involved in pretrial diversion or entered into a contract through juvenile court, or arrested without a conviction
in which the record has not been expunged?
Have you ever been pardoned in any court? If so, please provide details as to the crime and conviction in which the record has not been expunged.
Have you ever entered into any pretrial diversion program as an adult in which the record has not been expunged?
Have you been convicted of a crime as an adult or juvenile?
Have you entered a plea of guilty, a plea of no contest, a plea of “nolo contendere,” an Alford plea, or a plea of delinquency in juvenile court, or have
you received a deferred prosecution or prayer for judgment continued to a criminal charge?
Have you otherwise accepted responsibility for the commission of a crime or entered a pre-trial/diversion program?
Do you have any criminal charges pending against you?
1. _Yes __No
2. _Yes __No
3. _Yes __No
4. _Yes __No
5. _Yes __No
6. _Yes __No
7. _Yes __No
8. _Yes __No
Have you ever been assigned or received out-of-school suspension (OSS) or been expelled from high school, or placed on disciplinary probation or
suspension by any college or university? This may include, but is not limited to, academic cheating, conduct violations, or alcohol policy infractions. If you
answer “yes,” you must submit a statement from an appropriate school official to corroborate your explanation of the incident(s).
If you do not supply an explanation, we may request additional inforamtion to complete your application.
9.
Yes No Have you received any type of discharge, other than an honorable discharge, from military service?
If you have not served in the military, respond “No.”
Written statement (required for all “yes” responses):
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
21.
If you have been separated from high school or college for more than six months or one term, please explain how you have been using your time.
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
22. APPLICATION AGREEMENT
I certify that these responses are true and complete to the best of my knowledge, pursuant to reasonable inquiry where needed, and I am aware that any knowing omissions or falsifications
herein may result in disciplinary action including denial of admission or dismissal after admission. Further, it is my understanding that I shall not be considered for admission to the
University until I have submitted all credentials. I agree to inform the Office of Admissions in writing of any change in my plans to attend the University and any change to my responses
to questions on this application. I understand that if I discontinue my enrollment in a major term at Coastal Carolina University at any time, I must submit a new application by the
appropriate deadline. l also understand that the provision of my Social Security number and my ethnicity/racial origin are not required to be considered for admission to the University.
My signature below is my promise that, should I enroll at Coastal Carolina University, I will abide by all rules and policies of the Code of Student Conduct and Academic Responsibilities
as outlined in the University’s Student Handbook. A copy of the handbook can be found at coastal.edu/deanofstudents. Failure to truthfully disclose information may subject me to
immediate expulsion.
Signature of Applicant _______________________________________________________________________________________________________________ Date _____________________________________
Signature of Parent or Legal Guardian ___________________________________________________________________________________________________ Date _____________________________________
(if applicant is under 18 years of age)
APPLICATION FEE:
Credit card authorization for payment of the application fee (Complete this section only if you are paying the application fee by credit card. Please PRINT clearly.)
I authorize the use of my credit card account. AMOUNT: $_________________________ Please check the appropriate card: MasterCard Visa Discover American Express
Name (as it appears on credit card) ______________________________________________________________________________________________________________________________________________
Signature ________________________________________________________________________________________________ Daytime telephone ( ______________ ) _________________________________
16-digit Credit Card Number __________________ – __________________ – __________________ – __________________ Expiration date _____________ – ______________
Residents of the State of South Carolina are required to complete ONE of the residency information forms on
this application. If you do not provide this information, you will be classified as an out-of-state student for
tuition and fee purposes.
(Rev. 7/15)
14. FAMILY CONTACT INFORMATION (CHECK RELATIONSHIP TO YOU)
PARENT
SPOUSE
GUARDIAN
OTHER ________________________________________
NAME LAST ________________________________________________________________________ FIRST
MIDDLE ___________________________________________________________________________ SUFFIX (JR., III, IV) __________________________
HOME/PERMANENT ADDRESS • P.O. BOX, RFD, STREET _
CITY _____________________________________________________________________________ STATE _______________ ZIP CODE ____________________ ZIP + FOUR _
HOME TELEPHONE
( _______________ ) _____________________________________________
WORK TELEPHONE
( ______________ )
CELL TELEPHONE
( _______________ )
EMAIL ADDRESS
15.
I PLAN TO ATTEND CLASSES
Full time
Part time
16. MAJOR _________________________________ Specialization, if applicable ____________________________________ . (For readmission of former Coastal Carolina University students only.)
17. DOYOU CLAIM RESIDENCY IN SOUTH CAROLINA FOR PURPOSES OF IN-STATE TUITION?
Y es
No If YES, you must complete one of the residency forms on the back of this application.
Complete the Dependent Residency Information Form if you RECEIVE more than half our your support from a parent, guardian or spouse.
Complete the Independent Residency Information Form if you PROVIDE more than half of your support and you will NOT be claimed as a dependent or exemption on the
income tax return of a parent, guardian or spouse.
If all questions are not answered completely, you will be considered an OUT-OF-STATE student for tuition and fee purposes.
ADADEMIC HISTORY
18. HIGH SCHOOL FROM WHICH YOU WILL GRADUATE OR GRADUATED: (for Pre-College High School Students only)
____________________________________________________________________________________ ___________ __________________________ _________________ to _________________
Name of high school State CEEB HS Code Years attended (yyyy to yyyy)
19. COLLEGES ATTENDED: Have you attended any college, either full time or part time, since graduation or taken any college-level courses while in high school?
If yes, please list below all colleges attended, current or most recent first, and ask the institution(s) to forward an official transcript of your work directly to the Office of Admissions,
Coastal Carolina University.
__________________________________________________________________________________ ____________ ________________ ______________________ _____________________
Name of school (full name) State Credits earned Date entered (mm/yy) Date leaving (mm/yy)
__________________________________________________________________________________ ____________ ________________ ______________________ _____________________
Name of school (full name) State Credits earned Date entered (mm/yy) Date leaving (mm/yy)
__________________________________________________________________________________ ____________ ________________ ______________________ _____________________
Name of school (full name) State Credits earned Date entered (mm/yy) Date leaving (mm/yy)
Have you earned an Associate of Arts or an Associate of Science degree?
Yes
No
20. NON-ACADEMIC ADMISSION REVIEW
All applicants are required to respond to a series of non-academic admission review questions on the admission application. Responses to these questions are initially reviewed by
the Office of Admissions and Merit Awards. Some cases are referred to the non-academic admission review committee for further review. This non-academic review process supports
the University’s goal of maintaining a safe learning community. Failure to submit complete responses and/or falsification of responses may result in revocation of the admission decision
or dismissal of the student if false information or incomplete responses are discovered after enrollment. Any incident resulting in any change to a non-academic admission review
question subsequent to the application must be immediately reported by the applicant, in writing, to the Office of Admissions and Merit Awards. Failure to do so may result in the
revocation of the admission decision or dismissal of the applicant after enrollment. In addition, registered sex offenders are not allowed to enroll in classes or participate in campus
activities. Failure to disclose registration at any time shall result in immediate dismissal.
The University reserves the right to place conditions on the admission of any student. In the event such action is taken, the conditions will be clearly explained in the letter of acceptance.
If you answer “yes” to questions 1-9 below, we may request that you provide additional documentation to complete your admission application. A separate request for this information will be
mailed to you after the initial review of your answers to the non-academic review questions.
1.
Yes No Have you been adjudicated, processed, involved in pretrial diversion or entered into a contract through juvenile court, or arrested without a conviction
in which the record has not been expunged?
2.
Yes No Have you ever been pardoned in any court? If so, please provide details as to the crime and conviction in which the record has not been expunged.
3.
Yes No Have you ever entered into any pretrial diversion program as an adult in which the record has not been expunged?
4.
Yes No Have you been convicted of a crime as an adult or juvenile?
5.
Yes No Have you entered a plea of guilty, a plea of no contest, a plea of “nolo contendere,” an Alford plea, or a plea of delinquency in juvenile court, or have
you received a deferred prosecution or prayer for judgment continued to a criminal charge?
6.
Yes No Have you otherwise accepted responsibility for the commission of a crime or entered a pre-trial/diversion program?
7.
Yes No Do you have any criminal charges pending against you?
8.
Yes No Have you ever been assigned or received out-of-school suspension (OSS) or been expelled from high school, or placed on disciplinary probation or
suspension by any college or university? This may include, but is not limited to, academic cheating, conduct violations, or alcohol policy infractions. If you
answer “yes,” you must submit a statement from an appropriate school official to corroborate your explanation of the incident(s).
If you do not supply an explanation, we may request additional inforamtion to complete your application.
9.
_Yes _No
Have you received any type of discharge, other than an honorable discharge, from military service?
If you have not served in the military, respond “No.”
Written statement (required for all “yes” responses):
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
21.
If you have been separated from high school or college for more than six months or one term, please explain how you have been using your time.
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
22. APPLICATION AGREEMENT
I certify that these responses are true and complete to the best of my knowledge, pursuant to reasonable inquiry where needed, and I am aware that any knowing omissions or falsifications
herein may result in disciplinary action including denial of admission or dismissal after admission. Further, it is my understanding that I shall not be considered for admission to the
University until I have submitted all credentials. I agree to inform the Office of Admissions in writing of any change in my plans to attend the University and any change to my responses
to questions on this application. I understand that if I discontinue my enrollment in a major term at Coastal Carolina University at any time, I must submit a new application by the
appropriate deadline. l also understand that the provision of my Social Security number and my ethnicity/racial origin are not required to be considered for admission to the University.
My signature below is my promise that, should I enroll at Coastal Carolina University, I will abide by all rules and policies of the Code of Student Conduct and Academic Responsibilities
as outlined in the University’s Student Handbook. A copy of the handbook can be found at coastal.edu/deanofstudents. Failure to truthfully disclose information may subject me to
immediate expulsion.
Signature of Applicant _______________________________________________________________________________________________________________ Date _____________________________________
Signature of Parent or Legal Guardian ___________________________________________________________________________________________________ Date _____________________________________
(if applicant is under 18 years of age)
Residents of the State of South Carolina are required to complete ONE of the residency information
forms. If you do not provide this information, you will be classified as an out-of-state student for tuition
and fee purposes.
(Rev. 02/18)
click to sign
signature
click to edit
click to sign
signature
click to edit
For additional information, contact:
Coastal Carolina University
Offi ce of Admissions
P.O. Box 261954 • Conway, SC 29528-6054
843-349-2170 or 1-800-277-7000 • 843-349-2127 fax
admissions@coastal.edu • coastal.edu
Application for Undergraduate Admission
Readmission and Nondegree Students
Nondegree Admissions
A nonrefundable application fee of $45 is required with this application for all
nondegree applicants. Applicants who wish to attend the University for one
semester or for up to 18 credit hours may be approved to do so upon submitting
this application. The Offi ce of Admissions reserves the right to determine the proper
category of admission. Applications must be approved prior to the fi rst day of the
semester. Enrollment will not be permitted after classes are in session. Students in
a nondegree status are not eligible for fi nancial aid.
Students will be required to complete a new Application for Undergraduate
Admission (Readmission and Nondegree Students) and submit the required
processing fee if they are not continuously enrolled during the regular fall and
spring semesters (excludes summer terms).
• Transient Students are students who wish to take courses at Coastal Carolina
University while regularly enrolled in another “home” institution. Students are
responsible for securing approval from the Academic Dean or University Registrar
at their “home” institutions. Transient students are eligible to apply for on-campus
housing during summer sessions only. For more information, contact the Offi ce of
University Housing, 843-349-6400.
• Pre-College High School Students may be eligible to begin college studies
on a course availability basis while concurrently enrolled in high school. Pre-college
applicants must provide a high school transcript with a minimum B+ average through
the junior year and acceptable PSAT, SAT or ACT scores, along with a letter of
recommendation from a high school counselor or principal.
• Adult Learners are applicants who seek to enroll in courses for personal or
professional enhancement and who are at least 22 years old. At the completion of
18 credit hours, it is required that the student apply for degree-seeking status by
submitting a new Application for Undergraduate Admission, accompanied by offi cial
transcripts from all previously attended institutions.
NOTE: Senior citizens (age 60 or older) who are legal residents of South Carolina and
who are not employed full time may be eligible to attend classes on a space available
basis without the payment of tuition (excludes required course fees), provided the
applicant meets the admission requirements and other standards of the University.
Senior citizens may register for classes under the free tuition provision the day prior to
the fi rst day of class for the current term. The senior citizen must complete either the
Nondegree or Degree-Seeking Undergraduate Application depending on the status of
enrollment that is desired. In addition, the Free Tuition Application for Senior Citizens
must be completed and submitted to the Offi ce of Admissions.
Readmission of Former Coastal
Carolina University Students
To be considered for readmission,
undergraduate students who are
returning to the University after missing
a major term (fall or spring semester)
must complete this application, submit
the nonrefundable application fee of
$15 and provide offi cial transcripts for
all institutions attended after leaving
the University. Summer sessions do
not count as a major semester in this
instance. Readmission to the University
and to the program in which the student
was previously enrolled is not automatic.
Students who are seeking readmission
after the fi rst suspension must complete
this application and submit it to the
Offi ce of Admissions. Students who are
seeking readmission after the second
suspension must seek readmission
through the Academic Suspension
Petitions Committee. Students who
desire to return after a second or
indefi nite suspension must complete
the Academic Suspension Appeal form
and return it to the Offi ce of the Dean for
the student’s respective college. Should
permission to return to the University be
granted, then the student must complete
and submit this application along with
the nonrefundable application fee.
Students who have attended other
colleges since leaving the University are
required to submit offi cial transcripts.
Earning a Degree at
Coastal Carolina University
Students who wish to earn a degree
from Coastal Carolina University must
complete the Undergraduate Application
for Degree-Seeking Students and
submit the required application fee and
transcripts. The application can
be completed online at:
coastal.edu/admissions/apply.html.
7/15
COASTAL CAROLINA
UNIVERSITY
Offi ce of Admissions – Residency
Coastal Carolina University • P.O. Box 261954 • Conway, SC 29528-6054 • 843-349-2170 or 1-800-277-7000 • 843-349-2127 FAX
scresidency@coastal.edu • coastal.edu/admissions/residency
Coastal Carolina University (CCU) does not discriminate on the basis of race, color, religion, sex, national origin, age, genetic information, mental or physical disability, or status as a
disabled or Vietnam-era veteran in its admissions policies, programs, activities or employment practices. For more information relating to discrimination, please contact the CCU Title IX
Coordinator/EEO Investigator; Coastal Carolina University, Kearns Hall 104B, Conway, SC; Title IX email titleix@coastal.edu; office phone 843-349-2382; Title IX cell phone 843-333-6229;
EEO email eeo@coastal.edu; or the U.S. Dept. of Education Office for Civil Rights at http://www2.ed.gov/ocr.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

COASTAL CAROLINA UNIVERSITY Application for Undergraduate Admission Readmission (Coastal Carolina University)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 18 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document