COLLEGE DAYS REGISTRATION and Application for UNDERGRADUATE Admission U.S. High School or Academy Seniors
	SSL Certificate       Complete the form and click next at end of form (no application fee required)   Double check all spelling and be as complete as possible.
	Personal Data Your Full Legal Name:    Jr. II III IV Sr.   Last Name (Family Name or Surname) First Name Middle Name Suffix    Mr. Ms. Miss Mrs. Dr.   First Name you prefer to be called Previous Last Name(s) Title Date of Birth:    January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933   Gender:   Male     Female   Month Day Year   U.S. Social Security Number:         (This is a secure server, your personal information will be safe) E-Mail Address:      FAX number:      (If available)   (If available) Home Address:    Number and Street City State Zip Code Country (if not USA) Phone Numbers:      Home Phone Cell Phone (if available) Work Phone (if available) Temporary Address: (if different from Home Address)    Number and Street City State Zip Code Country (if not USA) Temporary Phone Number: (if different from Home Phone)         Date you are leaving this address:   January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2009 2010 2011 2012   Month Day Year Your Religion:   Nation of Citizenship:           Nation of Birth:     If you are not a U.S. Citizen, indicate your U.S. Immigration Status:      Non-Resident Alien/Foreign Student      Permanent Resident with Green Card      Other     Ethnicity:  Check which one applies. Your response is voluntary and will be used in a nondiscriminatory manner consistent with applicable civil rights laws   Black or African American Native American or Alaskan Native Asian or Pacific Islander   Hispanic White/Caucasian Other/Unknown Enrollment Information When do you wish to start your attendance?            select date January 2010 (spring semester) August 2010 (fall semester) January 2011 (spring semester) August 2011 (fall semester) January 2012 (spring semester) August 2012 (fall semester) January 2013 (spring semester) August 2013 (fall semester) January 2014 (spring semester) August 2014 (fall semester) Have you applied to Southwestern Adventist University before?     Yes     No Have you attended Southwestern Adventist University before?     Yes     No Southwestern Adventist University has over 40 majors and offers several undergraduate degrees which include a two-year Associate of Science (A.S) and four different four-year Bachelor degrees:   Bachelor of Arts (B.A.), Bachelor of Science (B.S.), Bachelor of Business Administration (B.B.A.), and Bachelor of Social Work (B.S.W.).   Southwestern Adventist University also offers a one-semester English as a Second Language (ESL) program for students whose primary language is not English. Students who successfully complete this ESL program may enter a regular degree program. What major do you wish to study?            must select one Accounting, B.B.A. Adventist Colleges Abroad (ACA) Biology, B.A. Biology, B.S. Business (teacher certification), B.S. Business Administration, B.B.A. Business Admin. & Computer Info. Systems, B.S. Chemistry, B.A. Chemistry, B.S. Clinical Laboratory Sciences, B.S. Computer Science, B.S. Elementary Education, B.S. Education - Teacher Certification (post degree) English, B.A. English as a Second Language, no degree Exercise Science, B.S. General Studies, A.S. General Studies, B.S. General Studies, no degree (not eligible for Federal aid) General Studies, pre-professional History, B.A. Interdisciplinary Studies, B.A. Interdisciplinary Studies, B.S. International Business, B.B.A. Journalism, B.A. Journalism, B.S. Life Science (teacher certification), B.A. Life Science (teacher certification), B.S. Management, B.B.A. Management, B.S. Marketing, B.B.A. Mathematical Physics, B.S. Mathematics, B.A. Mathematics, B.S. Medical Technology, B.S. Music Nursing, B.S. Nursing, (BS completion—R.N. required), B.S. Office Technology, A.S. Physical Education, B.S. Physical Science-Chemistry (teacher certification), B.S. Physical Science-Physics (teacher certification), B.S. Physics, B.S. PR and Advertising, B.A. PR and Advertising, B.S. Psychology, B.S. Radio-TV-Film, B.A. Radio-TV-Film, B.S. Religion, B.A. Social Science, B.A. Social Science, B.S. Social Studies (teacher certification), B.S. Teacher Certification (post degree) Theology, B.A. Undecided B.S. Undecided, no degree (not eligible for Federal aid) Wellness, A.S. Wellness, B.S.   if uncertain, then select General Studies, B.S.   Southwestern Adventist University offers preparatory classes for selected professions but does not offer degrees in these areas.   If you wish to pursue pre-professional studies, indicate the area:        may select one Anesthesiology Chiropractic Dentistry Dental Assisting Dental Hygiene Dietetics and Nutrition Engineering Law Medicine Occupational Therapy Optometry Osteopathy Pharmacy Physical Therapy Podiatry Public Health Veterinary Medicine X-Ray Technician if uncertain of the major above, select General Studies, pre-professional as major  Which type of enrollment do you wish?   As a traditional on-campus student   (New Freshman or Transfer)   (Full-time or Part-time)   As an auditing student (No credit)   As an ESL student (English as a Second Language) (Full-time Program)   As a transient student (1 semester only at SWAU — earn degree elsewhere)   As an ADEC student (Adventist Distance Education Consortium — earn degree elsewhere) Housing Plans:    Dormitory     Off-Campus Housing Financial Aid:   Will you be applying for Financial Aid?   (U.S. Citizens and U.S. Residents may be eligible for Financial Aid)   Yes     No   Will you be applying for benefits under the G.I. Bill?   (U.S. veterans and dependents) Yes     No Academic History Which one of the following academic classifications best applies to you at this time?   Not Graduated from High School   Graduated from High School, no college credit earned   College Freshman (1−12 sem hrs)   College Freshman (13−23 sem hrs)   College Sophomore (24−55 sem hrs)   College Junior (56−89 sem hrs)   College Junior (56−89 sem hrs) with a previously earned two-year college degree   College Senior (90+ sem hrs)   College Senior (90+ sem hrs) with a previously earned two-year college degree   Already have a four-year college degree Indicate the tests you have taken:   (Check all that apply)   SAT (Scholastic Aptitude Test) ACT (American College Test)   CLEP (College Level Exam Program) GED (General Education Development)   Michigan Test of English TOEFL (Test of English as a Foreign Language High School (Secondary Education Level)  Name of High School (whether you graduated or not):             City        State or Country  Which of the following best applies to you?   Graduated from High School Year:   2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948   Will graduate from High School Year:   2009 2010 2011 2012 2013 2014   Passed the GED or a state high school equivalency test   Year:   2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948   Will take the GED or a state high school equivalency test   Year:   2009 2010 2011 2012 2013 2014   Will not complete High School nor take GED   List each College or University you have attended   (List each school one time only):    School City State or Country Degree(s) earned Dates of attendance    School City State or Country Degree(s) earned Dates of attendance    School City State or Country Degree(s) earned Dates of attendance    School City State or Country Degree(s) earned Dates of attendance    School City State or Country Degree(s) earned Dates of attendance    School City State or Country Degree(s) earned Dates of attendance Please ask all Colleges and Universities you have attended to send official transcripts to: Admissions Office Southwestern Adventist University Keene, TX 76059 If you have completed less than 12 college hours, we will also need an official transcript from the last High School you attended. If you took the GED, then we will also need an official GED Test Report Personal Conduct   In High School or College have you been placed on probation for disciplinary reasons?   Yes No   In High School or College have you been suspended for disciplinary reasons? Yes No   In High School or College have you been dismissed for disciplinary reasons? Yes No     Have you been convicted of a misdemeanor? Yes No   Have you been convicted of a felony? Yes No           If you have been incarcerated, last release date:   January February March April May June July August September October November December after 2009 2009 2008 2007 2006 2005 2004 2003 2002 before 2002      Month  Year     Have you used tobacco in the past six months? Yes No   Have you used alcohol in the past six months? Yes No   Have you used drugs in the past six months? Yes No If you answer YES to any of these questions in this section, you need to explain in the space below (what/why/when/where,etc). Include a statement of your goals for the future:    College Days Information Date Attending:        select date October 8-11, 2009 November 5-8, 2009 Housing Will you be staying in the dormitory during College Days?   Yes   No     If Yes,  which nights? Thursday   Friday   Saturday   Meals Please check all meals   or check the specific meals you wish to eat at SWAU:       Thursday Friday Sabbath Sunday  breakfast      lunch      supper   T-Shirt   Please indicate your T-Shirt size:   select one X Small Small Medium Large X Large XX Large XXX Large Extracurricular Information Interests   check all that apply    Band Orchestra Choir   Drama Gymnastics   Hobbies List your hobbies, intramural sports interests, and other general interests: Colleges List colleges and universities other than SWAU that you are considering for next year: Emergency Contact Information Parent or Guardian:   Name:       Phone Numbers:                   Home Phone     Cell Phone (if available)     Work Phone (if available)   E-Mail Address:     (if available) Student Pledge By electronically submitting this application, I certify that the above statements are correct and complete.   I understand that incomplete or false information may make me ineligible for admission to or continuation at Southwestern Adventist University.