Undergraduate Degree Or Certificate - University College (Page 2 of 3) in pdf

Undergraduate Degree Or Certificate - University College Page 2

Optional:

To comply with Federal Law, Washington University is required to request the following racial/ethnic information.

Which of the following do you identify with? (You may check more than one.)

Hispanic or Latino

Asian

Prefer not to answer

American Indian or Alaska Native

Black or African American

Native Hawaiian or other Pacific Islander

White

Employment Information

Employer’s Name: _____________________________________________ Work Phone: (___)____ - _________

Present Occupation and Position: _________________________________________________________________

Employer’s Address 1: __________________________________________________________________________

Address 2: ____________________________________________________________________________________

City: __________________________________________State: ___________________Zip:___________________

Please list your previous employment record. If you not been employed full time, list summer and part-time work if

relevant to this application:

Employer

Type of Work

Inclusive Dates

Previous Education

High School: _______________________________________ Year of Graduation: ______________________

Please list, in chronological order, all colleges and universities attended. Official transcripts are required.

College or University

Dates Attended

Degree Earned

Have you previously applied, been admitted, or enrolled at Washington University in St. Louis? ____Yes ____No

If yes, please complete the information below.

Division

Application Date

Admitted Y/N

Enrolled Y/N

Undergraduate Degree Or Certificate - University College Page 2