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College Application Checklist

Belowisalistofinformationyouwillneedinordertocomplete youronlinecollegeapplication.It isbesttogooverthesequestions withafamily member andwritetheanswertoeachquestionin thespaceprovided.Havingyourcompleted College Application Checklist willhelpyoutosavetimeandkeeptrackoftheinformationneeded tocompleteapplications.

FULL NAME: ______

BACKGROUNDRESIDENCYINFORMATION
1.Currentmailingaddressand countyof residence
IfyourmailingaddressisaPostOfficeBox, youwillalsoneedaphysicalstreet address.
2.SocialSecurityNumber (optional)
3.Placeof birth:
City
State
Country
4.Areyoua U.S.citizen?(Yes/No)
5.Ifyouarenota U.S.citizen,enteryourINS SEVIS,ifyouhaveone,aswellasthe followinginformation(ifapplicable):
PermanentResidentNumber
Visatype
Non-immigrantvisanumber and expiration
Ifyouareaninternationalstudent,have youtakentheTOEFL(dateandscore)?
6.DateyoumovedtoArizona.
Thismaybeyourdateofbirth.
7.Driver’slicensenumberand date issued.
8.DatesandlocationsofplacesyouhavelivedoutsideofArizonainthepastfiveyears.
Dates:Location:
Dates:Location:

______

FAMILYINFORMATION
9.Areyoueligible forVeteransAffairs(VA)
benefits?
10.Areyouactivedutymilitaryora military dependent?
Ifyes,includedutystationandhomeofrecord.
11.Areyoua militarydependent?
Ifyes,expirationdateofmilitaryIDcardandsponsor’s dutystation.
Note:Ifyouhavealegalguardian,answerthe
questionsin#12 forthatpersonandfillinthe following information requestedontheright side.
12.Placeanddateofguardian appointment: Cityandcounty
Stateandcounty
Firstdesignatednextofkin/relationship Seconddesignatednextofkin/ relationship
13.Areyourmotherandfather living?
(required)
14.Parents first, middle and last names.
(optional)
15.IsyourfatheraU.S.citizen?
Ifnot,countryoforigin? (optional)
16.IsyourmotheraU.S.citizen?
Ifnot,countryoforigin? (optional)
17.Homeaddressofmotherandfather, ifdifferentfromyours. (optional)
18.Datesyourparentshavebeenliving atthe homeaddress.(optional)

______

19. Mother’s employment information.
(optional):
Occupation Employer Address
Dates employed Hoursperweek Worktelephone
20.Father’s employment information.
(optional):
Occupation Employer Address
Dates employed Hoursperweek Worktelephone
21.Mother’s educational background with collegeattended,ifapplicable. (optional)
22.Father’s educational background with
collegeattended,ifapplicable. (optional)
23.Parents’ marital status.(optional)
24. Custodystatus–pleaseselect.
Ifparentsareseparatedordivorced(optional)
Jointcustody– Mother andfather Solecustody– Mother orfather Other (please specify):
25.EmergencyContactInformation
(otherthanparent(s)orguardian)
Name Address Homephone Workphone
Familyphysician
Physicianphone
26.Listanysiblingsbynameandagewithanycollegesattendedincluding dates.
Name / Age / College / Dates

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27.Namesandrelationshipofanyrelativeswhoattendedinstitutions towhichyoumayapply.
Name / Relationship / College / Dates
COLLEGEAPPLICATIONMISCELLANEOUSINFORMATION
28.Towhatothercollegeshaveyouappliedordoyouplantoapply?
Name(s) / Location(s)
29.Intendedprogram(s)ormajor(s)
30.Nameandaddressofchurch (if any)(optional)
HIGHSCHOOLINFORMATION
31.Highschoolname Mailingaddress
City
County
State
Country
32.Dateofentry
33.Graduationdate
34. Courseofstudy(i.e.,collegetech prep,etc.)
35. Schoolcounselor name
Phonenumber
Faxnumber
Note:Beabletoprovidetheinformationrequestedin#31 forotherhighschoolsyoumayhave attended.

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ACADEMICINFORMATION
36.Listthecoursesyouaretakingduring senioryear.PleaseindicateanythatareHonors,AP,orIB.
FallSemester / SpringSemester
Other(SummerSchool, Online,etc.)
37.Listanycollegeyouhaveattended withaddressanddatesorcoursesforwhichyou expecttoreceivecollegecreditandhave receivedcollegecredit.
38. CollegeEntranceTestsDatesandScores
Test / Date / Score(s)
PSAT
ACT
SAT
SATSubjectTest(s)
COMPASS
ACCUPLACER/CPT
ASSET
TOEFL

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EXTRACURRICULAR,HONORSandEMPLOYMENTINFORMATION
39.Extracurricular activities:
Listinorderofimportancewithdates, positionsheld,honors,andawards.
40.Academichonors/awards:
Listthesewithnamesanddates.
(e.g.NationalHonorSociety,2009
AlgebraIIAward,2008).
41.Employment information:
Listanyjobs,internships,andvolunteer positionswithdates,places,hoursper week,andabriefdescriptionof responsibilities.
42. Youmaybeaskedtoanswerthefollowingquestions andtoprovide anexplanationforanyto
whichyou respond “yes.”
Haveyoubeenconvicted ofacrime?
Haveyouenteredapleaofguilty, apleaofnocontest,apleaofnolocontendere,oranAlfredplea;
orhaveyoureceivedadeferredprosecutionorprayerforjudgmentcontinuedforacrime? Haveyouotherwiseacceptedresponsibility forthecommissionofacrime?
Doyouhaveanycriminal chargespendingagainstyou?
Haveyoueverbeenexpelled,dismissed,suspended,placedonprobation,orotherwisesubjectto anydisciplinarysanctionbyanyschool,college,oruniversity?
Ifyouhaveeverservedinthemilitary,didyoureceiveanytypeofdischargeotherthananhonorable discharge?
43.Duringanyschoolyear,haveyoubeenoutof schoolforreasonsotherthanroutine vacations, disability-relatedreasons,orschool-relatedactivities?
44.Hasitbeen3 monthsormoresinceyou graduated,orsinceyouhavebeenenrolled in school?

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