Honors Application - Norfolk State University Page 2

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Honors Application-forprinter:Layout 1 2/7/2013 4:04 PM Page 2
APPLICATION FORM
A fillable PDF version of this form is also available online at
PROGRAM SELECTION — Please select the Program of Interest:
Parsons General Honors Program (all majors)
Discipline-Specific Honors Program in one of the following:
Business (Accounting, Entrepreneurial Studies, Finance, Management Information Systems, Marketing)
Physical Education and Exercise Science
Health Services Management
History
Interdisciplinary Studies
Nursing
Psychology
Social Work
Technology
Other (from website)
®
Please consult the DSHP website for any programs made available since the printing of this application.
Check your status
High School Student
Transfer Student
Transfer Student with Associate’s of Science, Arts or Arts and Sciences
Continuing NSU Student
(Note: Students entering with an associate’s degree listed above need only take 18 hours of Honors courses for a special diploma.)
GENERAL INFORMATION
1.
Today’s Date:
Term of Entry:
(Fall/Spring)
(Year of Entry)
2.
Name:
Last
First
MI
Student ID
Male
Female
3.
Address:
City:
State:
Zip Code:
Phone Number:
Cell Phone Number:
Email Address:
4.
List all honors courses taken in high school or at another institution of higher learning. Attach a separate sheet if necessary.
5.
List honors or awards you have received while in high school or at an institution of higher learning.
6.
List extracurricular activities.
HIGH SCHOOL INFORMATION (High School Applicants Only, Fill Out This Section.)
7.
High School:
8.
Full Address:
9.
Counselor’s Name:
Counselor’s Telephone Number:
10. Special diploma expected or awarded (e.g., International Baccalaureate):
11. State your most recent high school rank and the number of students in your class:
out of a total of
Transfer Students from VIRGINIA COMMUNITY COLLEGES or OTHER INSTITUTIONS OF HIGHER LEARNING.
(Transfer Applicants Only, Fill Out This Section.)
12. Name of Higher Learning Institution:
13. Full Address:
14. Please indicate your degree, if applicable:
®
15. Academic Advisor’s Name:
Advisor’s Phone Number:
2 • Honors College Application
Honors College Application • 7

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