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Non-Degree Seeking Application

 

Please complete each item thoroughly. You may use the TAB key to move from one field to another. If you have any problems filling out this form, please call 1-888-8GO-BORO or 814-732-2761 and a counselor will be happy to answer your questions. Thank you!

(*) denotes required information.

Personal Information:  
* Email:
* First Name:
Middle Initial:
* Last Name:
Maiden/Former Name:
* Address:
* City:
* State:
* Zip:
Home Country(if not US):
* Home Phone:
Cell Phone:
* Gender:
* Date of Birth:
* Are you a legal resident of Pennsylvania?
If 'Yes', how many years have you lived in Pennsylvania?
 
Citizenship/Ethnic Background:  
* Citizenship:
What is your ethnicity?
Hispanic or Latino
Not Hispanic or Latino
What is your race? Mark one or more races to indicate what you consider yourself to be
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
 
Next of Kin and Relationship:  
* Relationship:
* First Name:
Middle Initial:
* Last Name:
* Address:
* City:
* State:
* Zip:
* Phone:
 
High school of graduation OR high school equivalency (GED):
* High School:
* City:
* State:
* Year of Graduation:
 
Previous Institutions:  
List names and dates of any institutions at which you have attempted college level course work regardless of the length of time attended or credits earned beginning with the most recent institution. Failure to list all previous institutions (including business, trade, and technical schools) could result in disciplinary action. If attending a branch campus, please list the branch campus’s city and state. Advanced Placement tests and AP test preparation courses are not considered for this section.
Current or most recently attended Institution’s Name:
 
First Institution Name:
City:
State:
Dates of Attendence:
Degree Earned:
Degree Earned Date:
 
Second Institution Name:
City:
State:
Dates of Attendence:
Degree Earned:
Degree Earned Date:
 
Third Institution Name:
City:
State:
Dates of Attendence:
Degree Earned:
Degree Earned Date:
 
If you have attended another college or university, are you eligible to return for further study? You must be in good standing at a previous institution to be accepted at Edinboro.
Are you eligible to return for further study?
If no, explain:
 
Application Information:  
* Semester Applying for:
Your parent, guardian, or spouse is employed by Edinboro University:
Highest degree earned by your parents or guardians:
You plan to apply for financial aid:
* List course(s) you would like to take at Edinboro (include course name and code number):
* Please explain why you are applying as a Special Student:
 
I would like to attend classes at:  
Edinboro University's main campus in Edinboro, PA:
Edinboro University in Erie - The Porreco Center:
Edinboro University in Meadville - The Buba Center:
Edinboro University courses at a partner community college:
 
Submit Application:  
By entering the date on this form and submitting this information, you certify that the information is correct and understand that any misrepresentation by you on this application form could lead to future disciplinary action by the University.
* Date:
 

All documents submitted to the University on behalf of a student's request for admission become the property of Edinboro University and cannot be returned.