FOR ALL PREREQUISITE COURSEWORK - COMPLETED, IN PROGRESS, AND PLANNED
Were all courses and labs taken in traditional, in-person format? Yes No
If No, please list the course/s and a brief description of the format (i.e., hybrid, on-line, etc.); include the course number/s shown on the previous page of this form:
DEGREE(S) EARNED / TO BE EARNED
ENROLLMENT INFORMATION
1. Have you previously applied to Baldwin Wallace University? No Yes, Dates__________________________________________________________
2. Do you plan to apply for financial aid (FAFSA)? No Yes
BACKGROUND INFORMATION
1. Have you ever been found responsible for a disciplinary violation at any college you have attended, whether related to academic or behavioral misconduct that
resulted in your probation, suspension, removal, dismissal or expulsion from the institution? No Yes
2. Have you ever been found guilty or convicted of a misdemeanor or felony that was not expunged or sealed? No Yes
Note: Although students with an expunged record may be eligible for enrollment and clinical placement in BW’s
program, an expunged record may impact a student’s eligibility to qualify for a professional license following
completion of the program. Eligibility for a professional license varies by state and may be assessed on a
case-by-case basis by the professional licensing board.
3. Have you ever tested positive for drug or alcohol use on a urine drug screen? No Yes
If you answered ‘Yes’ to any of these BACKGROUND INFORMATION questions, please use the space below to give the approximate date and location of each
incident, with explanation of the circumstances of each incident.
REQUIRED ACKNOWLEDGMENT
Please click on box to express agreement with statements and thereby allow for processing of your Application Supplement.
I hereby certify that all information in my application is factually true and honestly presented. I understand that any misrepresentation may be cause for denial or
cancellation of admission.
Date: _____________________________________
