First/Given Name:    Middle Name:

Last/Family Name:

Gender: Male Female        Date of Birth:   Month    Day    Year 

Mailing Address in Home Country:

Country:     Home Country Phone:

Country of Birth:     Country of Citizenship:

Complete this section only if you are currently living in the United States:

What type of VISA do you hold? (Attach a copy)

What is your U.S. mailing address?

What is your U.S. telephone number?

List your parent(s) or guardian(s) name and address:
#1





Phone Number:     Relationship:

#2





Phone Number:     Relationship:

Are any of your relatives graduates of Edinboro University? Yes No    If yes, date of graduation:

Name:

Housing Status (check one):
Residence Hall
Off-campus (non-university housing in the town of Edinboro) Not available to freshmen and those under 22 years of age.

Starting date for which you are applying:      September January Summer     Year:

Student Classification (check one):
Freshman (first-time college student)
Transfer (previously attended another post-secondary institution)
Exchange

If a transfer student, please list all previous post-secondary institutions:

Have you ever applied to Edinboro University before?
Yes No      Date:

If yes, did you enroll in class?
Yes No      Date:

If you are not currently enrolled in school, what are you doing now?

How did you hear about Edinboro University?  

Date you took (or plan to take) the Test of English as a Foreign Language (TOEFL):

Month:         Year:        Score:   

All students from countries where English is not the official language must participate in the TOEFL exam. Only in extenuating circumstances will exceptions be made to this requirement. The TOEFL institutional code number for Edinboro University is 2651. The minimum acceptable TOEFL score is 173 (computer based) or 500 (paper based) for admission to Edinboro.

SUMMARY OF EDUCATIONAL EXPERIENCES

Complete all information for each school you attended, beginning with primary or elementary school and ending with your current or most recent school. Do not try to describe your education in terms of the United States educational system unless you have attended U.S. schools. Use the terms familiar to your country.

Attach an additional sheet of paper if necessary.

• School name.


• The city and country where the school is located.


• The month and year you began studies at the school; the month and year you finished.


• The kind of school, for example: elementary, gymnasium, lycee, colegio, secondary college, university.


• The name of external examinations you took or expect to take before you come to Edinboro University, and the name of certificates, diplomas, or degrees you received or expect to receive before you come to Edinboro. For example: HKCE, GCE A-Levels, MCE, HSC, WASC, Abitur, Bachillerato, Baccalaureate, Associate Degree. List all education you completed or expect to complete before coming to Edinboro University. Give all results, including failures.


• The date external examinations and/or the date certificates, diplomas, or degrees were awarded.

#1

Name of School:
Address:
Dates of Attendance:
Type of School:
Examination, Certificate, Diploma, Degree:
Date Received:

#2

Name of School:
Address:
Dates of Attendance:
Type of School:
Examination, Certificate, Diploma, Degree:
Date Received:

#3

Name of School:
Address:
Dates of Attendance:
Type of School:
Examination, Certificate, Diploma, Degree:
Date Received:

Edinboro University of Pennsylvania is committed to affirmative action to assure equal opportunity for all persons, regardless of race, color, religion, national origin, or sex. We are in compliance with Title IX.

I certify the information provided on this application is accurate and complete, and understand that all required credentials must be submitted before an admissions decision can be made. I accept complete responsibility for requesting that official transcripts of record be forwarded directly to the Edinboro University Admissions Office from each school attended. Furthermore, I agree to abide by all the rules and regulations of Edinboro University of Pennsylvania.

Signature:       Date: