ONLINE UNDERGRADUATE APPLICATION FORM



 

Freshman Applicants
Please call 1.888.359.5782

  • A completed application (online or regular) - Please call 1.888.359.5782 for assistance
  • Official high school transcript(s)
  • Results of either an ACT or SAT examination if you are an athlete (applicants holding a high school equivalency diploma may submit official results of a G.E.D. examination in place of high school transcripts and ACT/SAT scores)
  • A $20 application fee (call 1.888.359.5782 for details)

Transfer Applicants
Please call 1.888.359.5782 for assistance

  • All of the items listed above in the instructions to Freshman Applicants
  • Official academic transcripts from each college/university you have attended or are currently attending
  • Transfer Student Personnel Records from each college/university you have attended (upon receipt of your application, the Salem International University Office of Admissions will send you one personnel record form for each college/university listed on your application. It is your responsibility to have those forms completed and returned to Salem International University)
  • Financial Aid transcripts must be mailed to the Salem International University Office of Admissions
  • A $20 application fee (call 1.888.359.5782 for details)
 
RED indicates a required field.
PERSONAL INFORMATION
First Name:
Middle Name:
Last Name:
Birth Date: / /
Social Security Number:
NOTE: If Social Security Field is left blank you will be contacted by an admissions counselor for this information.
E-mail Address: 
Home Phone: ( )
Sex:
Marital Status:
Are you a US Citizen?
Are you a permanent US Resident?
If your answer was NO to both questions above you are filling out a wrong application. Click here to get to the right application.
Ethnic Origin (This question is optional and is used for statistical purposes only):
PERMANENT ADDRESS INFORMATION
Number and Street:
City:
State County:
State:
Zip:
MAILING ADDRESS INFORMATION
Same as Permanent Address
Number and Street:
City:
State County: State:
Zip:
If mailing address is different than permanent address, include dates - FROM:
TO:
ENROLLMENT INFORMATION
NOTE: Choose Special Student Status only if you are a non-degree seeking student!
  I intend to be enrolled primarily
I am applying for enrollment in:
I am applying for:  status.
Have you ever applied to S-TU or SIU?:
If Yes, when?:
College Residence:
Intended Major:
BILLING INFORMATION Same as Permanent Address
Name:
Phone: ( )
Number and Street:
City:
State County: State:
Zip:
PARENT, GUARDIAN INFORMATION
Does either parent have a 4 year Degree?
Mr. Mrs. Dr. Ms. Mr. & Mrs. Dr. & Mrs. Rev. & Mrs.
First Name: Middle Name:
Last Name:
FATHER'S OCCUPATION INFORMATION
Position:
Employer: City:
State:
MOTHER'S OCCUPATION INFORMATION
Position:
Employer: City:
State:
GUARDIAN'S OCCUPATION INFORMATION
Position:
Employer: City:
State:
FINANCIAL AID INFORMATION
Will you be applying for financial aid?:
Has your FAFSA been mailed to the U.S. Department of Education?:
If Yes, when?: / /
PREVIOUS EDUCATION INFORMATION
Secondary Schools
List all secondary schools, beginning with the most recent, and include date(s) of graduation and anticipated date of graduation.

I have a GED

 HIGH SCHOOL GPA
1. School: from: /
to: /
  City: State:
Date of Graduation:
2. School: from: /
to: /
  City: State:
Date of Graduation:
3. School: from: /
to: /
  City: State:
Date of Graduation:
Colleges and Universities
List all colleges and universities attended, beginning with the most recent.

COLLEGE GPA
1. College/Univ.: from: /
to: /
City: State:
Date of Graduation:
2. College/Univ.: from: /
to: /
City: State:
Date of Graduation:
3. College/Univ.: from: /
to: /
  City: State:
Date of Graduation:
References
Please list three references. One must be your guidance counselor, one your English teacher, and one of your choice.
1. Name: Position:
Phone (w):
2. Name: Position:
Phone (w):
3. Name: Position:
Phone (w):
OTHER INFORMATION
Have you ever been dismissed or placed on probation by any high school or institution of higher education?:
If yes please explain:
Have you ever been convicted of a felony:
If yes please explain:
Do you have any special needs or requirements:
List academic Honors Earned (Honor Societies, etc.):

Indicate activities, offices held in high school and years of participation (Sports, Student Government, Publications, Music, Theater, Civic Groups, etc.):

To which other colleges do you plan to apply for admission?