Application For Undergraduate Admission - Concordia University (Page 4 of 4) in pdf

Religious Affiliation

(Optional)

Religious Affiliation _______________________________________________________________________________

Home Congregation _______________________________________________________________________________

Church Address ___________________________________________________________________________________

STREET

CITY

STATE

ZIP

Church District ___________________________________________________________________________________

If Lutheran, are you a member of the Missouri Synod? q Yes

q No

Ethnicity and Race

(Optional)

Are you Hispanic or Latino? — A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish origin,

regardless of race.

Yes

Check all that apply:

American Indian or

Asian — A person having

Black or African American

Native Hawaiian or other

Alaskan Native

origins in any of the original

— A person having origins

Pacific Islander

— A person having origins

peoples of the Far East,

in any of the black racial

— A person having origins

in any of the original

Southeast Asia or the Indian

groups of Africa.

in any of the original

peoples of North and

subcontinent including, for

peoples of Hawaii, Guam,

White — A person having

South America (including

example, Cambodia, China,

Samoa and other Pacific

origins in any of the original

Central America), and who

India, Japan, Korea, Malaysia,

Islands.

peoples of Europe, the

maintains a tribal affiliation

Pakistan, the Philippine

Middle East or North Africa.

Prefer not to respond

or community attachment.

Islands, Thailand and Vietnam.

How Did You Hear About Concordia?

(Please check all that apply.)

q Advertisement

q Concordia mailer

q Internet

q Campus visit

q Concordia website

q Magazine/newspaper article

q Coach

q Friend/relative

q Pastor/youth leader

q College fair

q High school counselor

q Radio

q Concordia alumnus/a

q High school visit

q Other ______________________

Signature

I hereby give Concordia University, St. Paul permission to use my likeness in any promotional or news release generated by the

university or any agent appointed by the university. This information may contain photos of me, quotes from me or statistical

information about me. I also give Concordia University permission to print my name in regard to any honors I receive from the

university. If you are not in agreement with these terms, please contact the Office of Admissions directly.

I hereby certify that all information given is complete and accurate to the best of my knowledge.

Your signature signifies that all information and statements on this application are accurate and true. Falsification of information

contained within this application could affect the status of your financial aid or enrollment at Concordia University, St. Paul.

Applicant Signature ____________________________________________________ Date ______________________

Completed applications and application fee should be sent to Concordia. Make checks or money orders payable to

Concordia University, St. Paul.

*Application fee is waived for students who make an official campus visit.

Submit application to Concordia:

Mail:

Email:

Concordia University, St. Paul

admissions@csp.edu

Office of Admissions

Fax:

1282 Concordia Avenue

651-603-6320

St. Paul, MN 55104

Concordia University, St. Paul is registered as a private institution with the Minnesota Office of Higher Education pursuant to sections 136A.61 to 136A.71. Registration

is not an endorsement of the institution. Credits earned at the institution may not transfer to all other institutions.

Concordia University does not discriminate for admission of students on the basis of race, color, creed, religion, national or ethnic origin, disability, sex, age, marital

status, veteran or veteran disability status, or sexual orientation.

Application For Undergraduate Admission - Concordia University Page 4

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