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    UNDERGRADUATE APPLICATION FOR ADMISSION

    *To be official, transcripts must be sealed and mailed to Georgia Southern by the school that you attended or submitted through gacollege411.

    IF YOU ARE AN ENTERING FRESHMAN

    Complete the application form (7 pages).

    Be sure to attach your $30 non-refundable application fee payable to Georgia Southern University (check or money order only, please).

    Be sure your date of birth and signature are on your application form and on your check or money order.

    Ask your high school counselor to mail your application, along with your official* high school transcript, to:Office of Admissions, Georgia Southern University, P.O. Box 8024, Statesboro, GA 30460-8024

    When you take the SAT or ACT, request that a copy of your score report be sent to Georgia Southern. Our school code is 5253 for the SAT and 0830 for the ACT.

    IF YOU ARE A TRANSFER STUDENT

    Complete the application form (7 pages).

    Be sure to list all of the colleges you have previously attended.

    Be sure your date of birth and signature are on your application form and on your check or money order.

    Be sure to attach your $30 non-refundable application fee payable to Georgia Southern University (check or money order only, please).

    Submit the application form to the Office of Admissions, Georgia Southern University, P.O. Box 8024, Statesboro, GA 30460-8024.

    Request an official* transcript from each college you have previously attended.

    If you have completed fewer than 30 semester or 45 quarter hours have your high school send us your official* transcript and make sure it includes your SAT/ACT scores. If not, then please submit the scores separately from the testing agency. Our school code is 5253 for the SAT and 0830 for the ACT.

    APPLY EARLY FOR ADMISSION

    In order to be processed for admission for a specific term, applications must be received by the Office of Admissions by the following dates:

    Fall Semester May 1 (freshman) / August 1 (transfer or Accel/joint enroll)Spring Semester December 1Summer Semester April 1

    Normally, all students who have applied or updated their applications prior to the application deadline for a specific term will be considered for admission.However, the University reserves the right to cease accepting or processing applications at any time. Therefore, students are encouraged to apply or update wellin advance of the application deadline for their intended term. International applicants must submit materials 30 days prior to the standard deadline.

    REQUIRED HIGH SCHOOL CURRICULUM

    Students who graduate from high school in 2012 or later must present credits for seventeen (17) specified units. Students who graduated earlier than 2012 mustpresent credit for sixteen (16) specified units. The 17 (16 for students who graduated in 2011 or earlier) specified USG units are:

    1. Mathematics: Four (4) units of Mathematics, including Algebra I, Algebra II, and Geometry. For students who graduate from a Georgia public school in 2012or later, the 4 units of Mathematics must include a course at the level of Math 3 or higher.

    2. English: Four (4) units of English which have as their emphasis grammar and usage, literature (American, English, World), and advanced composition skills.

    3. Science: Students who graduate in 2012 or later must have four (4) units of science. Three (3) units of science are required for those who graduated in2011 or earlier. Students need at least one laboratory course from the life sciences and one laboratory course from the physical sciences. Georgia publichigh School graduates must have at least one (1) unit of biology, one (1) unit of physical science or physics, and one (1) unit of chemistry, earth systems,

    environmental science, or an advanced placement science course.

    4. Social Science: Three (3) units of social science, with at least one (1) course focusing on United States studies and one (1) course focusing on world studies.

    5. Foreign Language: Two (2) units in the same foreign language emphasizing speaking, listening, reading, and writing. Two (2) units of American SignLanguage may be used to satisfy this requirement.

    Students will be accepted during their senior year based on high school average and SAT/ACT scores on the condition that the course requirements will be met.The courses required for regular admission to institutions of the University System represent the minimum standards set forth by the Board of Regents.

    Contact the Office of Admissions for specific information at [email protected] or 912-478-5391.

    If your first language is not English, we will require the Michigan Test in addition to the TOEFL.

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    STUDENT NAME

    Last Name First Name Middle Name

    Suffix (Ex: Jr, Sr, II, III) Preferred First Name Former Name

    MAILING ADDRESS

    Street City

    State Zip Country

    CONTACT INFORMATION

    Home Phone Number Daytime Phone Number Cell Phone Number

    E-mail Address

    BIOGRAPHICAL INFORMATION

    Social Security Number Sex Male Female

    Race (Check all that apply) American Indian/Alaskan Native Asian Black/African American Native Hawaiian/Pacific Islander White

    Ethnicity Hispanic Non-Hispanic

    Date of Birth City of Birth Country of Birth

    Citizenship Status Born U.S. Citizen Naturalized Citizen Permanent Resident (Foreign U.S. Resident) Alien (Foreign Non-resident)

    If non-resident alien or permanent resident, what is your country of citizenship?

    If you currently reside in the U.S. but are not a U.S. citizen or a permanent resident, what is your current immigration status?

    Provide visa type and number:

    How long have you lived in the US? Month(s) Year(s)

    Native Language English Other Have you taken the TOEFL? Yes No

    CAMPUS SPECIFIC INFORMATION

    Parent/Guardian 1/Spouse: First Name Last Name Middle Initial Suffix

    Street City State Zip

    Phone Number E-mail Address Relationship Father Mother Guardian/Other Student Spouse

    Georgia Southern Graduate Yes No

    Employer Title Highest Degree Earned Never Attended High School Some High School High School Diploma

    Technical School Some College Bachelor Degree

    Masters Degree Professional Degree Doctoral Degree

    Parent/Guardian 2: First Name Last Name Middle Initial Suffix

    Street City State Zip

    Phone Number E-mail Address Relationship Father Mother Guardian/Other Student Spouse

    Georgia Southern Graduate Yes No

    Employer Title Highest Degree Earned Never Attended High School Some High School High School Diploma

    Technical School Some College Bachelor Degree

    Masters Degree Professional Degree Doctoral Degree

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    EMERGENCY CONTACT

    First Name Last Name Relationship

    Street City

    State Zip Phone Number

    OTHER INFORMATION

    Have you ever been convicted of a crime other than a minor traffic violation?

    Yes No

    If yes, explain in 100 words or less.

    Have you ever entered a plea of guilty, a plea of no contest, a plea of nolo contendere, an Alford plea to a criminal charge, or a plea under a first offender act? Yes No

    If yes, explain in 100 words or less.

    Do you currently have disciplinary or academic misconduct charges pending against you from a high school or a postsecondary institution?

    Yes NoIf yes, explain in 100 words or less.

    Have you ever been disciplined, suspended, or expelled for conduct code violations from a high school or a postsecondary institution?

    Yes No

    If yes, explain in 100 words or less.

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    ADMISSION INFORMATION

    Applicant Type High school graduate or will be graduating high school this year

    GED

    Accel/Joint Enrolled or Move on When Ready with Georgia Southern

    Joint Enrolled with another college

    Mature (out of high school 5 or more years)

    Transient (Will attend Georgia Southern for 1 semester only)

    Jr. College Transfer (Attending a 2-year institution)

    Sr. College Transfer (Attending a 4-year institution)

    Post Graduate (Already have a Bachelors degree)

    Which semester do you plan to enter? Fall Spring Summer Year

    For major, please check one of the Undergraduate or Pre-professional programs:

    UNDERGRADUATE PROGRAMS

    Accel/Joint Enrolled Transient Transient East Georgia College

    Accounting

    Athletic Training

    Anthropology

    Art - Studio Art

    Art - 2D Drawing, Painting, Print, Paper & Book Arts

    Art - 3D Ceramics, Sculpture, Jewelry & Metals

    Art - Graphic Design

    Art History

    Biology

    Biology - Education

    Broadcasting

    Business

    Business - Education

    Chemistry

    Chemistry - Education

    Child & Family Development

    Communication Studies

    Community Health

    Computer Science

    Construction Management

    Early Childhood Education

    Economics

    Engineering - Civil Engineering - Electrical

    Engineering - Mechanical

    Engineering - RETP - Aerospace

    Engineering - RETP - Biomedical

    Engineering - RETP - Chemical & Biomolecular

    Engineering - RETP - Civil

    Engineering - RETP - Computer

    Engineering - RETP - Electrical

    Engineering - RETP - Environmental

    Engineering - RETP - Industrial

    Engineering - RETP - Materials Science

    Engineering - RETP - Mechanical

    Engineering - RETP - Nuclear & Radiological

    Engineering - RETP - Polymer, Textile & Fiber

    English

    English - Education

    Exercise Science

    Fashion Merchandising & Apparel Design

    Finance

    French/Modern Languages

    General Studies

    General Studies - Web

    Geography

    Geography - Education

    Geology

    German/Modern Languages

    Graphic Communications Management

    Health & Physical Education

    History

    History - Education

    Information Systems Information Technology

    Information Technology - Web

    Interior Design

    International Studies

    International Trade

    Journalism

    Justice Studies

    Logistics & Intermodal Transportation

    Management

    Marketing

    Mathematics

    Mathematics Education

    Middle Grades Education

    Music

    Music Composition

    Music Education - Choral Sequence

    Music Education - Instrumental Sequence

    Music Performance - Instrumental

    Music Performance - Jazz/Piano

    Music Performance - Piano

    Music Performance - Voice

    Nursing

    Nutrition & Food Sciences/Dietetics

    Philosophy

    Physics

    Physics - Education

    Political Science

    Political Science - Education

    Psychology

    Public Relations

    Recreation Sociology

    Spanish/Modern Languages

    Special Education

    Speech Communication

    Sport Management

    Theater

    Undeclared

    Writing & Linguistics

    * RETP (Regional Engineering Transfer Program)

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    PRE-PROFESSIONAL PROGRAMS

    Pre-Dentistry/Biology

    Pre-Dentistry/Chemistry

    Pre-Dentistry/Physics

    Pre-Law

    Pre-Medicine/Biology

    Pre-Medicine/Chemistry

    Pre-Medicine/Physics

    Pre-Optometry/Biology

    Pre-Pharmacy/Biology

    Pre-Pharmacy/Chemistry

    Pre-Veterinarian

    HIGH SCHOOL INFORMATION

    Full Name of High School Graduation Date

    City County State

    Senior year high school courses you have taken or will complete this year prior to enrolling at Georgia Southern University

    Course Title Credit

    1.

    2

    3.

    4.

    5.

    6.

    TEST INFORMATION

    Have you taken the SAT?

    Yes No

    What was the combined Critical Reading & Math score? Did you have the scores sent to Georgia Southern?

    Yes No

    Have you taken the ACT?

    Yes No

    What was the composite? Did you have the scores sent to Georgia Southern?

    Yes No

    Have you taken AP exams?

    Yes No

    Subject(s)? Date Taken

    Have you taken International Baccalaureate?

    Yes No

    Subject(s)?

    Date Taken

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    CURRENT OR PREVIOUSLY ATTENDED COLLEGES

    College/University 1

    City State

    College/University 2

    City State

    College/University 3

    City State

    College/University 4

    City State

    College/University 5

    City State

    MILITARY SERVICE

    Are you currently active duty military or a family member (spouse or child) of someone who is active duty military?

    Yes* No

    Are you currently a member of the Georgia National Guard or a family member (spouse or child) of someone who is a member of the Georgia National Guard?

    Yes* No

    What is your (or your parent/guardian/spouse) home state of record?

    *If you answer yes to any of the above military-related questions, you may be asked to provide a copy of your current military ID card and orders assigning you to a Georgia military installation.

    RESIDENCY INFORMATIONUniversity System of Georgia students are responsible for registering under the proper tuition classification. In general, classification of in-state status for tuitionpurposes requires an individual to have established legal residency and domicile in Georgia for 12 consecutive months prior to enrolling.

    Residency is defined as the state and country where an individual currently lives. An individual may be residing in Georgia and may be classified as havingestablished Georgia residency for securing marital status, a drivers license, or classification of taxpayer status but does not meet the qualifications to establishdomicile in Georgia.

    Domicile is defined as a persons present, permanent home where that individual intends to stay indefinitely and to which that individual returns following periodsof temporary absence. Temporary residence does not constitute the establishment of ones domicile. To acquire domicile, an individual must demonstrate intent toremain permanently or indefinitely.

    In accordance with Board of Regents Policy 4.3.4, any student applying for in-state tuition will be required to provide validation of their lawful presence in theUnited States and proof of Georgia residency in order to be granted in-state tuition status.

    Are you applying for in-state tuition?

    Yes No

    According to the definitions above, have you established and maintained legal residency and domicile in Georgia for at least 12 consecutive months immediatelypreceding the first day of classes for the term in which you plan to enroll?

    Yes No

    If you are under the age of 24, has a parent(s) or U.S. court-appointed legal guardian established and maintained legal residency and domicile (according to thedefinitions above) in Georgia for at least 12 consecutive months immediately preceding the first day of classes for the term in which you plan to enroll?

    Yes No

    IF YOU ANSWERED YES TO ANY OF THE ABOVE QUESTIONS, ALL OF THE FOLLOWING QUESTIONS MUST BE ANSWERED.

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    RESIDENCY INFORMATION

    What is your Georgia county of residence?

    Have you ever lived outside the state of Georgia?

    Yes No

    If you have lived outside the state of Georgia, how long have you continuouslyresided in the state?

    Months Years

    If you have lived outside the state of Georgia, what was your primary reason for moving to the state of Georgia?

    Have you attended a Georgia high school for at least one year?

    Yes No

    Have you graduated, or will you graduate from a Georgia high school?

    Yes No

    Do you have a drivers license or state-issued ID?

    Yes No

    If yes, what state?

    Do you own a motor vehicle?

    Yes No

    If yes, what state?

    Do you have a voter registration?

    Yes No

    If yes, what state?

    Did you file a state income tax return in the past year?

    Yes No

    If yes, what state?

    Did your parent, court appointed legal guardian, or spouse claim you on theirstate income taxes in the last year?

    Yes No

    If yes, what state?

    First Name:

    Last Name:

    Relationship:

    Did your parent, court appointed legal guardian, or spouse claim you on their federal income taxes in the last year?

    Yes No

    APPLICATION CERTIFICATION & GEORGIA SOUTHERN UNIVERSITY HONOR CODE

    I understand that any material false statement made knowingly and willfully by me on this application, or any documents attached hereto may, in accordancewith O.C.G.A. 16-10-71, which provides that upon conviction, a person who knowingly commits the offense of false swearing shall be punished by a fine of notmore than $1,000 or by imprisonment for not less than one nor more than five years, or both, subject me to prosecution in a court of law. Additionally, I furtherunderstand than any such false statement may subject me to immediate dismissal from the institution.

    Further, I certify that, to the best of my knowledge, the information submitted on this application is true and complete.

    Georgia Southern University Honor Code

    On my honor, I pledge to be academically honest in all my coursework and will not tolerate the academic dishonesty of others. I also pledge to engage in ethicalbehavior on-campus and off-campus, to live an honorable lifestyle, and to create a campus environment that is characterized by individual responsibility, civility,and integrity.

    Signature ________________________________________________________________ Date ___________________________________

    Georgia Southern University Office of Admissions PO Box 8024 Statesboro, GA 30460 (912) 478-5391 admissions.georgiasouthern.edu

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