Admissions Application Packet v4--FINAL

1 Undergraduate Application Last name First name Middle name Previous name(s) Address City State Zip Parent/Spouse (circle one) Last name First name Middle initial Parent/Spouse Address City State Zip Home telephone number Business number Cell number... More

1 Undergraduate Application Last name First name Middle name Previous name(s) Address City State Zip Parent/Spouse (circle one) Last name First name Middle initial Parent/Spouse Address City State Zip Home telephone number Business number Cell number Gender: (check one) Male Female Birthdate: Social Security number: Citizenship: U. S. Citizen Permanent Resident (provide copy of form I-551) Nonresident Alien (request international application) (Wright State is required by the federal government to report this information, however, reporting it on this form is strictly voluntary for students. ) Ethnicity: Are you Hispanic or Latino? Yes No Race (select all that apply) Black or African American American Indian/Alaskan Native Asian Native Hawaiian/Other Pacific Islander White E-mail address High school attended City State ACT high school code Graduation date College/university attended City State First and last dates attended Degree(s) earned College/university attended Less