APPLICATION - FAMILY BACKGROUND
Father's name _________________ If deceased, when? _______________ _ Where employed? Position __________________ If father attended college, where? Number of years _______________ _ Mother's ful l name If deceased, when? ________________ (INCLUDE MAIDEN NAME) Where employed? ------------------------------------ 11 mother attended college, where? ___________ Number of years ________________ If parents are separated, give date of separation ----------------------------- MONTH YEAR If parents are separated, with whom do you live? --------------------------- Names and ages of children older than yourself: Brothers ___________ Sisters ___________ Names and ages of children younger than yourself: Brothers Sisters ___________ Members of your family who have attended Biol □ ---------------------------- EDUCATIONAL EXPERIENCE Anticipated (or past) graduation date from high school --------------------------- MONTH YEAR Name of high school ____________________________________ Address of high school ---------------------------------- CITY STATE If you have graduated from high school, list in chronological order your activities since high school graduation. (Schools attended, employment, military service, extended travel, etc.) Schools must be listed even though you do not expect transfer credit. Please include Biol □ extension courses, if applicable. School, Work, Travel Dates Have you earned a degree from any college or university? Yes D No D If yes, complete the following: College: __________________ Degree: ------------------ Major: Date Conferred: _______________ _ Have you ever been dismissed or placed on academic or disciplinary probation? Yes D No D If yes, explain the circumstances: The Scholastic Aptitude Test (SAT) or ACT is REQUIRED, unless as a transfer you will hove sophomore status (requires a minimum of 27 accepted units). Please indicate the testing date on which you plan to take (or have taken) the: SAT __________________ or ACT __________________ MONTH YEAR MONTH YEAR NOTE: Regardless of transfer status nursing majors and students seeking a teaching credential must take the SAT. Indicate your possible major--------------------------------- What are your vocational goals? -------------------------------- NURSING MAJORS: See catalog for procedures for acceptance into the school of nursing. Are you currentiy a Registered Nurse? __ALicensed Vocational Nurse? __ or enrolled in a nursing program? __ Separate application must be made to the nursing program for Registered Nurses, Licensed Vocational Nurses and oll others applying to the deportment of nursing. Nursing departmental application forms will be mailed upon receipt of this application. TRANSFER STUDENTS If you are transfering from another school, please explain your reasons for wonting to transfer:
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