Apply online! Go to http://admissions.tc.umn.edu/apply Application for 2016-2017 transfer Admission Deadline information is available online at http://admissions.tc.umn.edu/admissioninfo/trans_deadlines or in the 2016-2017 Transfer Student Guide. Personal information 1. Name first middle last 2. Former name if any first middle last 3. Social Security number (optional) 4. Date of birth (optional if 18 or older) day 5. Gender Providing the information below is voluntary and will not be used in a discriminatory manner. This question complies with the U.S. Department of Education s standards for gender data collection. Male Female 6. Ethnicity and Race Providing the information below is voluntary and will not be used in a discriminatory manner. These questions comply with the U.S. Department of Education s standards for ethnic and racial data collection. Definitions are available online at http://admissions.tc.umn.edu/apply/definitions. Ethnicity: Are you Hispanic or Latino? Race: Please select one or more that apply. American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander 7. Permanent address Home phone White number and street city/state/zip 8. Mailing address if different from above Other phone number and street city/state/zip Cell phone 9. Email address Important information about your application will be sent to this email address. Please provide the email address you check regularly. Intended Major 10. Semester you wish to begin Fall (September) 2017 11. Designate your intended major and corresponding college below. Enclosed is a list of undergraduate majors. (te: If you designate a major that is available at two colleges, choose your major based on your college of interest.) Intended major College Allied Health Programs (Medical Laboratory Sciences) Liberal Arts Continuing Education Food, Agricultural and Natural Resource Sciences If you have another major interest, indicate it here. College Allied Health Programs (Medical Laboratory Sciences) Liberal Arts Continuing Education Food, Agricultural and Natural Resource Sciences Undecided This option is only available to College of Liberal Arts applicants who have completed fewer than 60 semester credits by the first term of intended enrollment at the U of M; please list your academic interests below. *005006* Go on to page 2 1
12. Please provide a brief statement of your academic interests and career goals as they relate to your major choice or choices, including if you are still deciding on a major. Educational background 13. Is English your native language? 14. List the high school you graduated from and your date of graduation. If NO, how many s have you attended school in the United States? s. You may need to take the MELAB or TOEFL. See the Transfer Student Guide for more information. Name of high school City/State From (mm/yr) To (mm/yr) Graduation date 15. If you did not graduate from high school, did you earn a General Education Development (GED) diploma instead? If YES, GED certificate date 16. Check all course requirements you have successfully completed in high school. See the Transfer Student Guide. 4 s English 1 geography 1 intermediate algebra 2 s of a single second language 1 other social science 1 biological science 1 visual or performing arts 1 elementary algebra 1 physical science 1 U.S. history 1 geometry 1 other science 17. Have you previously enrolled at the University of Minnesota? If yes, complete questions A-B. A. U of M ID# (if known) B. Were you enrolled in a degree program? If you are transferring from one degree program to another on the Twin Cities campus, or are transferring from the U of M Crookston, Duluth, Morris, or Rochester, a different application is required. Go to http://policy.umn.edu/forms/otr/otr014.pdf 18. List all universities (including the U of M) or colleges at which you have registered or enrolled, regardless of whether you completed courses or earned credits, beginning with the most recent. Attach an additional sheet if necessary. Failure to report all institutions may result in denial of admission or cancellation of admission or enrollment. Degree completed? If yes, date completed Name of degree and major Degree completed? If yes, date completed Name of degree and major Degree completed? If yes, date completed Name of degree and major Degree completed? If yes, date completed Name of degree and major 2 Go on to page 3
19. List all university or college courses now in progress or that you plan to take before enrolling at the University of Minnesota. Attach additional sheet if necessary. Name of institution Term Dept Course # Course title Credits Term Dept Course # Course title Credits I will not be taking any courses before enrolling. Family educational background 20. Has either of your parents received a four- undergraduate degree from a college or university? 21. Have any members of your family attended the University of Minnesota Twin Cities? If yes, list their names and relationship to you. 22. Have any members of your family been employed by the University of Minnesota? If yes, list their names and relationship to you. Residency information 23. Are you a U.S. citizen? Go to #25. If no, complete questions A-C. A. Country of Citizenship B. Country of Birth C. I am a: Permanent resident (green card holder) Temporary visa holder Refugee/political asylee Other Please list type of visa (e.g., F-1, J-1, H-4, L-2) Please note: If you are in the U.S. on a temporary visa, the name listed on this application and your passport must match. You must also include your permanent home country address on page 1. 24. State in which you claim legal residence Minnesota Other please specify When did you move to that state? Lived there all my life OR Go on to page 4 3
Work experience 25. Work experience is one area in which applicants can demonstrate leadership and/or significant responsibility in a family, community, job, or activity. This information is taken into consideration during our holistic review of your application as part of the many secondary factors we consider. Please share any and all work experiences in this section. Place of employment City/State From (mo/yr) To (mo/yr) Job title Hours/week 26. Military service Are you currently serving or have you ever served in the U.S. Military? (The University Veterans Service Office will send admitted students information needed to receive veteran s benefits.) Are you a U.S. military service member currently deployed overseas? > If yes, you do not need to pay the application fee. We will contact you to obtain a copy of your deployment papers. Educational programs/activities 27. Please check any educational programs you have participated in that are relevant to your application. Minnesota Cooperative Admissions Program (MnCAP) CSE Dual Enrollment Program FFA Phi Theta Kappa 4-H Others 28. Please provide additional information concerning your extracurricular, individual, or volunteer activities. Attach additional sheet if necessary. Additional required information The University of Minnesota is committed to maintaining an educational environment characterized by safety, respect, and integrity. 29. The University of Minnesota is committed to maintaining a scholarly, educational environment characterized by safety, respect, and integrity. As part of this commitment, the University requires undergraduate applicants to supply information about their conduct. Applicants reporting academic dishonesty, criminal convictions or pending criminal charges are never automatically barred from admission to the University. Before the information below is considered, we will complete a holistic, overall assessment of the application and if it is determined that the applicant is academically admissible, only then will the responses be considered as one of the factors in our review. For more information about our process for considering this information, please visit http://admissions.tc.umn.edu/apply/conductfaq.html. I have been expelled from, suspended from, or placed on probation at any high school or college for academic dishonesty. I have been convicted of a felony or I have felony charges pending against me at this time. As an adult or juvenile, I have been found legally responsible for a sexual offense or I have sexual offense charges pending against me at this time. Applicants may also include an optional statement as to why they believe this information should not be cause for concern about the safety of the university community. te: Misrepresenting answers to these questions may result in the withdrawal of your application or admission. If your answers to the above questions change, you are required to notify the Office of Admissions and provide updated answers. 4 Go on to page 5
Special Circumstances or Additional Information (optional) 30. If you have any personal or additional information that you would like the admissions committee to consider in its holistic review of your application, please share that information below. Access to your file I authorize the University of Minnesota to give information about my application file, admission or scholarship status to the following person(s) (e.g., parent, relative, friend): name email relationship to you name email relationship to you Applicant s signature I certify that the information I have provided on this application and on all other application materials is complete, accurate, and true to the best of my knowledge. I understand that withholding pertinent information requested on this application or providing false information will make me ineligible for admission, or subject to cancellation of registration if admission has occurred, or subject to sanctions from the U of M, including dismissal, from the U of M, if already enrolled. I agree to notify the Office of Admissions if there are any changes to the information provided in my application. In addition, I authorize the release of information provided in my application, as well as my admission, honors, and scholarship status, to my high school and to scholarship donors. I also authorize the University of Minnesota to release the information provided by me, as well as other University of Minnesota information regarding my academic progress and status, to scholarship donors and the U of M Foundation for the purpose of providing them with information concerning my eligibility as a scholarship recipient. In addition, for the purposes of scholarship consideration, I authorize the release of information provided in my application to organizations including the University of Minnesota Foundation that award scholarships to incoming University of Minnesota students. applicant s name (please print) applicant s signature date Privacy statement: All information on the application form is private. The information requested will be used for identification, to determine admission and scholarship awards, and to establish your University academic record if you are admitted. thing is sold to any third parties. Failure to provide the information may delay or affect the admission or scholarship decision. Providing your Social Security number is voluntary and will be used for positive identification, institutional statistics, institutional research, and required state and federal reporting. Failure to provide your Social Security number will have no effect on the admission or scholarship decision. Information will be shared with offices within the University for the uses described above and may be released to outside organizations and government bodies in limited circumstances, as authorized by state or federal law. The University of Minnesota shall provide equal access to and opportunity in its programs, facilities, and employment without regard to race, color, creed, religion, national origin, gender, age, marital status, disability, public assistance status, veteran status, sexual orientation, gender identity, or gender expression. Inquiries regarding compliance may be directed to the Director, Office of Equal Opportunity and Affirmative Action, University of Minnesota, 274 McNamara Alumni Center, 200 Oak Street S.E., Minneapolis, MN 55455, 612-624-9547, eoaa@umn.edu. Website at www.eoaa.umn.edu. (This publication is available in alternative formats upon request. Please contact the Office of Admissions at 1-800-752-1000.) Your application materials may be shared with other University of Minnesota campuses (Crookston, Duluth, Morris, Rochester) for admission and scholarship consideration. The University of Minnesota reserves the right to deny admission to an otherwise admissible applicant if the University determines that the applicant s enrollment would not be in the applicant s and/or the University s best interest. Don t forget to submit: Official transcripts from all colleges attended (even if no credit was earned) $55 nonrefundable application fee (Check or money order payable to the University of Minnesota) Supplemental application A supplemental application is required for students applying to the Carlson School of Management; Center for Allied Health Programs (Clinical Laboratory Sciences); College of Design; College of Education and Human Development; Dental Hygiene; Dental Therapy; Mortuary Science; or Nursing. Links to the applications are available at http://admissions.tc.umn.edu/pdfs. Please note that some supplemental applications require an additional fee. Official high school transcripts or GED, if applicable* If you would like information about accommodations for a disability, either as a student or in the admission process, you may contact the Office of Disability Services at 612-626-1333 or the Office of Admissions at 612-625-2008. Applicants may receive, on request, information about graduation and retention rates from the Office of Admissions. Please note that individuals arrested, charged, or convicted of criminal offenses may have limited employment opportunities in specific careers and occupations and may have limited ability to receive federal, state, and other forms of financial aid. Individuals are encouraged to investigate these possibilities further. (Minnesota Statutes, Section 135A.157) The University produces an annual security and fire safety report. This report includes information on campus crime statistics, information relating to personal and campus safety, fire safety, and security policies and programs. The report is available online at www1.umn.edu/police/docs/clerybroch.pdf. To request a paper copy of this report, contact the U of M Police Department at 612-624-2677. Special notice regarding release of information on the application: The University of Minnesota may request that University staff, faculty, scholarship donors, alumni, and/or students assist you with questions concerning the University and to provide you with additional information. This would be done under the direction of Office of Admissions staff. The type of information that might be released includes name, address, phone number, classification (freshman or transfer), major, and most recent educational institution attended. If you do not wish to receive this particular service, please attach a letter to your application indicating your wishes in this matter. Official ACT or SAT scores, only if (1) you have graduated from high school and you have completed less than a full of college coursework (26 transferrable credits), OR (2) you are applying to Dental Hygiene. If scores appear on your high school transcript, you do not need to send a separate score report. *All applicants must turn in a high school transcript, except for those who have previously completed an A.A. degree or bachelor s degree. The high school transcript (or GED) is needed to determine: proof of graduation; whether you have completed the high school preparation requirements; and whether you have met all of the prerequisites for admission to your college of choice. To: Office of Admissions, University of Minnesota Twin Cities 240 Williamson Hall, 231 Pillsbury Drive S.E. Minneapolis, MN 55455-0213 Thank you! 5