SELECT APPLICATION PERSONAL INFORMATION (FIRST, MIDDLE, LAST, SUFFIX) PREFERRED FIRST If you wish, you may elaborate on your gender identity. OF BIRTH Sex Assigned at Birth: Male Female SOCIAL SECURITY NUMBER (OPTIONAL) U.S. Armed Forces Status: Currently Serving Previously Served Current Dependent Not Applicable PERMANENT ADDRESS STREET ADDRESS APT. # COUNTRY MAILING ADDRESS (if different from permanent address) Effective Dates of Mailing Address: From to STREET ADDRESS APT. # COUNTRY CITIZENSHIP Are you a U.S. citizen? Yes No Are you a dual citizen? Yes No Countries and If neither, then you are: A U.S. permanent resident (specify alien registration number) A U.S. visa holder (specify visa type) Other (specify your country of citizenship) Country of Birth Native Language (if not English) ETHNICITY (OPTIONAL) Are you Hispanic or Latino? Yes No Select one or more of the following races: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
YOUR FAMILY PARENT 1 RELATIONSHIP Mother Father Legal Guardian Other Female Male This person is: Living Deceased TITLE: Dr. Miss Mr. Mrs. Ms. R. Rev. PARENT 2 RELATIONSHIP Mother Father Legal Guardian Other Female Male This person is: Living Deceased TITLE: Dr. Miss Mr. Mrs. Ms. R. Rev. FIRST LAST FIRST LAST MAILING ADDRESS (IF DIFFERENT FROM YOURS) MAILING ADDRESS (IF DIFFERENT FROM YOURS) OCCUPATION EMPLOYER OCCUPATION EMPLOYER WORK PHONE WORK PHONE Did this person attend college? Yes No If so: Did this person attend college? Yes No If so: COLLEGE(S) DEGREE(S) EARNED COLLEGE(S) DEGREE(S) EARNED OF PROFESSIONAL OR GRADUATE SCHOOL (IF ANY) OF PROFESSIONAL OR GRADUATE SCHOOL (IF ANY) Please check if parents/guardians are Married Separated Divorced ( ) Other With which parent do you make your permanent residence? Both Parents Mother Father Legal Guardian Have any of your relatives attended Rollins College? Yes No RELATIONSHIP DEGREE/YEAR RELATIONSHIP DEGREE/YEAR Please list any brothers and/or sisters you have.
TEST INFORMATION The submission of your SAT or ACT scores is optional. Rollins provides a Test Score Waived Option (TSWO), which focuses the application review on your individual academic achievement, creativity and leadership instead of on standardized test scores. You can decide whether or not your test scores reflect your academic ability and potential. Details on the TSWO can be found at www.rollins.edu/admission/tswo. Are you submitting SAT/ACT test scores for consideration? Yes, I will submit my test scores. No, I want to be considered for the TWSO. IF YES, please give us your best score for each applicable category. SAT: When did you take the SAT? Prior to March 2016 In or since March 2016 Critical Reading/Evidence-Based Reading and Writing Score Math Score Writing/Essay Score ACT: Composite Score TOEFL/IELTS: Score Do you plan to take these tests in the future? If so, when? SAT ACT ACADEMIC INFORMATION CURRENT HIGH SCHOOL Type: Public Private Parochial Homeschool PREVIOUS HIGH SCHOOL (IF APPLICABLE) Type: Public Private Parochial Homeschool SCHOOL SCHOOL CODE SCHOOL SCHOOL CODE STREET ADDRESS STREET ADDRESS OF ENTRY (MONTH/YEAR) OF ENTRY (MONTH/YEAR) GRADUATION (MONTH/YEAR) REASON FOR CHANGING SCHOOLS YOUR COUNSELOR INFORMATION (FIRST, LAST) COUNSELOR YOUR ACTIVITIES Please list your high school activities in order of their importance to you (sports, service projects, clubs, special interests, work experience, etc.). Feel free to attach a résumé if you wish. 9 10 11 12 Have you engaged in community service beyond what is required by your school? Yes No ACADEMIC HONORS POSSIBLE MAJOR INTEREST(S) PERSONAL STATEMENT AND RÉSUMÉ We d love to learn more about you than the basic facts on this application. Tell us, in 250 words or more, something special about you. The topic is your choice be as creative as you like! If you d like to send a résumé to us, please include it with your application.
ENROLLMENT PLANS When do you plan to enroll? Spring 2018 (Classes start in January) Fall 2018 (Classes start in August) You are applying for (select one): Early Decision I (Nov. 1) Early Decision II (Dec. 15) Regular Decision (Feb. 1) Note: Our priority scholarship deadlines are November 1 and January 5. Have you previously applied to Rollins? Yes No Are you applying for the 3/2 Accelerated Management Program? Yes No This program combines a four-year Bachelor of Arts (BA) degree and a two-year Master of Business Administration (MBA) degree into a five-year program. Details can be found at www.rollins.edu/admission/amp. Separate from need-based financial aid, which of the following programs are you interested in pursuing to help fund your education at Rollins? Academic Scholarship (automatic consideration) Alfond Scholarship (automatic consideration) Athletic Scholarship (NCAA Division II) Bonner Leader Scholarship (service-based) Cram Scholarship (select science majors) Florida Resident Scholarship (Bright Futures, FRAG, etc.) Goings Scholarship (Boys & Girls Club members) Nelson Scholarship (music majors) Parker Scholarship (theatre majors) FINANCIAL AID INFORMATION The FAFSA: We encourage all students and their families to complete the Free Application for Federal Student Aid (FAFSA) regardless of income. Completing a FAFSA (our school code is 001515) and submitting it by the recommended December 1 deadline ensures that Rollins can consider you for all forms of need-based aid. Rollins offers need-based financial aid to international students. If you are an international student, a separate aid application will be sent to you. For more information, visit www.fafsa.ed.gov. Do you intend to apply for financial aid? Yes No
EARLY DECISION AGREEMENT The Rollins Early Decision program is for students who have decided to make Rollins their first-choice college and should not be confused with Early Action programs at other schools. If accepted under Early Decision, students must withdraw any applications to other colleges and enroll at Rollins. Rollins offers two rounds of Early Decision. Students applying Early Decision I must have their completed applications on file with us by November 1. Students applying Early Decision II must have their completed applications on file by December 15. Admission decisions are mailed two to four weeks after the application deadline. Students accepted under the Early Decision program have several advantages: Notification of the admission decision by December 15 (Early Decision I) or January 15 (Early Decision II) Priority in academic scholarship and financial aid consideration Once accepted, Early Decision candidates are expected to submit a $500 nonrefundable deposit and withdraw applications to other colleges. IF YOU ARE APPLYING AS AN EARLY DECISION CANDI, PLEASE READ AND SIGN THE FOLLOWING Rollins College is my first-choice college, and I would like to be considered for Early Decision admission. I will withdraw any applications to other colleges and enroll at Rollins if I am accepted under this program. FINAL STEPS Have you ever been adjudicated guilty or convicted of a misdemeanor or felony? [Note that you are not required to answer yes to this question or provide an explanation if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded or otherwise ordered by a court to be kept confidential.] Yes No Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the ninth grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal or expulsion from the institution? Yes No If you answered yes to either question, please provide a written explanation with your application. CERTIFY, SIGN AND I certify that the information on this application is complete and correct, and I understand that the submission of false information is grounds for denial of my application, withdrawal of any offer of acceptance, cancellation of enrollment or any appropriate disciplinary action. I authorize Rollins College to verify the information I have provided with all of the schools that I have attended. I agree to notify the proper officials of the institution of any changes in the information provided. I grant my high school(s) and college(s) permission to release my transcript(s) to Rollins. I waive my right to review or access letters and statements of recommendation written on my behalf. STUDENT SIGNATURE STUDENT SIGNATURE Applicants for admission are considered without regard to race, color, creed, age, gender, disability, sexual orientation or national origin. REMEMBER Check that your application is complete and all the information is correct. Submit your $50 application fee by check or money order. Send your official transcript(s) and test scores. Ask your counselor to submit a letter of recommendation and school report. Rollins College. Office of Admission. 1000 Holt Avenue 2720. Winter Park, FL 32789-4499. Phone: 407.646.2161. Fax: 407.646.1502