Application For Undergraduate Admission - Concordia University Page 2

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Enrollment Information
What term are you applying for at Concordia University, St. Paul? q Fall q Spring q Summer
Year: 20__ __
Entering status: q Freshman q Transfer
Do you plan to live on campus? q Yes
q No
Please note that freshmen and sophomores are required to live on campus if they are not living with their parents or legal guardian.
Do you plan to apply for financial aid? q Yes
q No
Before becoming at least a part-time student at a Minnesota post-secondary institution, did you or will you reside in
Minnesota for 12 consecutive months? q Yes
q No
By July 1, 2015, will you have graduated from a Minnesota high school while residing in Minnesota? q Yes
q No
Family Information
(Optional)
Guardian 1 q Contact in case of emergency
Guardian 2 q Contact in case of emergency
Name ______________________________________________
Name ______________________________________________
Home address _______________________________________
Home address _______________________________________
____________________________________________________
____________________________________________________
What is this person’s relationship to you? _________________
What is this person’s relationship to you? _________________
Phone ______________________________________________
Phone ______________________________________________
Email ______________________________________________
Email ______________________________________________
Is this person a Concordia St. Paul graduate? q Yes q No
Is this person a Concordia St. Paul graduate? q Yes q No
Siblings
Please give names and ages of your brothers or sisters. If they have attended or are currently attending college, give the names of the under-
graduate institution, degree earned and approximate dates of attendance. If more than two siblings, please list them on an attached sheet.
_____________________________________ School Attended __________________________Expected Graduation _______
NAME, AGE, RELATIONSHIP
_____________________________________ School Attended __________________________Expected Graduation _______
NAME, AGE, RELATIONSHIP
Family Legacy
Please list any immediate or extended relatives who have attended or graduated from Concordia University and years of graduation, if known.
This also includes the university’ s previous designation as Concordia College and Concordia High School.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Educational Record
Please list the names of ALL high schools, colleges and technical schools attended. It is your responsibility to request that all transcripts be
sent to Concordia. Failure to provide a complete academic record may result in withdrawal of acceptance. Please use and attach a separate sheet of
paper if necessary. Any transcripts from non-United States schools must be translated into English and evaluated by a credential evaluation company.
If you have extracurricular, church, community, academic honors or any other relevant information you would like considered, please
attach a résumé with your application.
Are you homeschooled? q Yes
q No
Do you have a GED? q Yes
q No
High School(s):
__________________________________________________________________________________________________________
NAME
CITY
STATE
DATES ATTENDED
GRADUATION DATE
__________________________________________________________________________________________________________
NAME
CITY
STATE
DATES ATTENDED
GRADUATION DATE
Colleges, Technical or Other Post-High School(s):
__________________________________________________________________________________________________________
NAME
CITY
STATE
DATES ATTENDED
GRADUATION DATE
__________________________________________________________________________________________________________
NAME
CITY
STATE
DATES ATTENDED
GRADUATION DATE
__________________________________________________________________________________________________________
NAME
CITY
STATE
DATES ATTENDED
GRADUATION DATE

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