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<!DOCTYPE HTML PUBLIC "-//IETF//DTD HTML//EN">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<meta name="GENERATOR" content="Microsoft FrontPage 2.0">
<title>apply</title>
</head>
<body bgcolor="#97DFAE">
<h1 align="center"><font size="5">Application for Admission</font></h1>
<h1 align="center">Sheldon Jackson College</h1>
<form method="POST" name="applyform" action="_vti_bin/shtml.dll/apply.htm" onSubmit webbot-action="--WEBBOT-SELF--">
<!--webbot bot="SaveResults" u-file="appres.htm" s-format="HTML/BR" s-label-fields="TRUE" s-builtin-fields="Date Time REMOTE_NAME REMOTE_USER HTTP_USER_AGENT" s-form-fields u-confirmation-url="appconf.htm" startspan --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--webbot bot="SaveResults" endspan i-checksum="43374" --><dl>
<dd><table border="0">
<tr>
<td colspan="2">First Name </td>
<td colspan="2"><input type="text" size="37" maxlength="256" name="FirstName"></td>
</tr>
<tr>
<td colspan="2">Last Name </td>
<td colspan="2"><input type="text" size="37" maxlength="256" name="LastName"></td>
</tr>
<tr>
<td colspan="2">Preferred Nickname </td>
<td colspan="2"><input type="text" size="28" maxlength="256" name="NickName"></td>
</tr>
<tr>
<td colspan="2">Previous Name (if any)</td>
<td colspan="2"><input type="text" size="27" maxlength="256" name="PreviousName"></td>
</tr>
<tr>
<td colspan="2">Street address </td>
<td colspan="2"><input type="text" size="35" maxlength="256" name="StreetAddress"></td>
</tr>
<tr>
<td colspan="2">Town</td>
<td colspan="2"><input type="text" size="15" maxlength="256" name="Town"></td>
</tr>
<tr>
<td colspan="2">State</td>
<td colspan="2"><select name="State" size="1">
<option selected>XX</option>
<option>AL</option>
<option>AK</option>
<option>AZ</option>
<option>AR</option>
<option>CA</option>
<option>CO</option>
<option>CT</option>
<option>DC</option>
<option>DE</option>
<option>FL</option>
<option>GA</option>
<option>HI</option>
<option>ID</option>
<option>IL</option>
<option>IN</option>
<option>IA</option>
<option>KS</option>
<option>KY</option>
<option>LA</option>
<option>ME</option>
<option>MD</option>
<option>MA</option>
<option>MI</option>
<option>MN</option>
<option>MS</option>
<option>MO</option>
<option>MT</option>
<option>NE</option>
<option>NV</option>
<option>NH</option>
<option>NJ</option>
<option>NM</option>
<option>NY</option>
<option>NC</option>
<option>ND</option>
<option>OH</option>
<option>OK</option>
<option>OR</option>
<option>PA</option>
<option>RI</option>
<option>SC</option>
<option>SD</option>
<option>TN</option>
<option>TX</option>
<option>UT</option>
<option>VT</option>
<option>VA</option>
<option>WA</option>
<option>WV</option>
<option>WI</option>
<option>WY</option>
</select></td>
</tr>
<tr>
<td colspan="2">Zip Code</td>
<td colspan="2"><input type="text" size="10" maxlength="10" name="ZipCode"></td>
</tr>
<tr>
<td colspan="2">Phone number (include area
code)</td>
<td colspan="2"><input type="text" size="14" maxlength="14" name="Phone"></td>
</tr>
<tr>
<td colspan="2">Email Address</td>
<td colspan="2"><input type="text" size="35" name="email"></td>
</tr>
<tr>
<td colspan="2"><input type="checkbox" name="Veteran" value="Yes">I am a Veteran</td>
<td colspan="2">&nbsp;</td>
</tr>
<tr>
<td colspan="2">Country of Citizenship</td>
<td colspan="2"><input type="text" size="25" maxlength="256" name="Citizen"></td>
</tr>
<tr>
<td colspan="2"><input type="radio" name="Female" value="female">Female </td>
<td colspan="2"><input type="radio" name="Male" value="male">Male </td>
</tr>
<tr>
<td colspan="2">High School town/state</td>
<td colspan="2"><input type="text" size="25" maxlength="256" name="HStownstate"></td>
</tr>
<tr>
<td colspan="2">High School name</td>
<td colspan="2"><input type="text" size="31" maxlength="256" name="HighSchool"></td>
</tr>
<tr>
<td colspan="2">High School graduation year</td>
<td colspan="2"><input type="text" size="4" maxlength="4" name="Gradyear"></td>
</tr>
<tr>
<td colspan="2">Social Security Number
(optional)</td>
<td colspan="2"><input type="text" size="12" maxlength="12" name="SSN"></td>
</tr>
<tr>
<td colspan="2">Birthdate</td>
<td colspan="2"><input type="text" size="25" maxlength="25" name="Birthdate"></td>
</tr>
<tr>
<td colspan="2"><strong>Colleges Attended:</strong></td>
<td colspan="2">&nbsp;</td>
</tr>
<tr>
<td colspan="2">College Name</td>
<td colspan="2"><input type="text" size="33" maxlength="256" name="College1"></td>
</tr>
<tr>
<td>State</td>
<td><select name="College1State" size="1">
<option>AL</option>
<option selected>AK</option>
<option>AZ</option>
<option>AR</option>
<option>CA</option>
<option>CO</option>
<option>CT</option>
<option>DC</option>
<option>DE</option>
<option>FL</option>
<option>GA</option>
<option>HI</option>
<option>ID</option>
<option>IL</option>
<option>IN</option>
<option>IA</option>
<option>KS</option>
<option>KY</option>
<option>LA</option>
<option>ME</option>
<option>MD</option>
<option>MA</option>
<option>MI</option>
<option>MN</option>
<option>MS</option>
<option>MO</option>
<option>MT</option>
<option>NE</option>
<option>NV</option>
<option>NH</option>
<option>NJ</option>
<option>NM</option>
<option>NY</option>
<option>NC</option>
<option>ND</option>
<option>OH</option>
<option>OK</option>
<option>OR</option>
<option>PA</option>
<option>RI</option>
<option>SC</option>
<option>SD</option>
<option>TN</option>
<option>TX</option>
<option>UT</option>
<option>VT</option>
<option>VA</option>
<option>WA</option>
<option>WV</option>
<option>WI</option>
<option>WY</option>
</select></td>
<td>Credits earned </td>
<td><input type="text" size="3" maxlength="3" name="College1credits"></td>
</tr>
<tr>
<td colspan="2">College Name</td>
<td colspan="2"><input type="text" size="33" maxlength="256" name="College2"></td>
</tr>
<tr>
<td>State</td>
<td><select name="College2State" size="1">
<option>AL</option>
<option selected>AK</option>
<option>AZ</option>
<option>AR</option>
<option>CA</option>
<option>CO</option>
<option>CT</option>
<option>DC</option>
<option>DE</option>
<option>FL</option>
<option>GA</option>
<option>HI</option>
<option>ID</option>
<option>IL</option>
<option>IN</option>
<option>IA</option>
<option>KS</option>
<option>KY</option>
<option>LA</option>
<option>ME</option>
<option>MD</option>
<option>MA</option>
<option>MI</option>
<option>MN</option>
<option>MS</option>
<option>MO</option>
<option>MT</option>
<option>NE</option>
<option>NV</option>
<option>NH</option>
<option>NJ</option>
<option>NM</option>
<option>NY</option>
<option>NC</option>
<option>ND</option>
<option>OH</option>
<option>OK</option>
<option>OR</option>
<option>PA</option>
<option>RI</option>
<option>SC</option>
<option>SD</option>
<option>TN</option>
<option>TX</option>
<option>UT</option>
<option>VT</option>
<option>VA</option>
<option>WA</option>
<option>WV</option>
<option>WI</option>
<option>WY</option>
</select></td>
<td>Credits earned</td>
<td><input type="text" size="3" maxlength="3" name="College2credits"></td>
</tr>
<tr>
<td colspan="2">College Name</td>
<td colspan="2"><input type="text" size="33" maxlength="256" name="College3"></td>
</tr>
<tr>
<td>State</td>
<td><select name="College3State" size="1">
<option>AL</option>
<option selected>AK</option>
<option>AZ</option>
<option>AR</option>
<option>CA</option>
<option>CO</option>
<option>CT</option>
<option>DC</option>
<option>DE</option>
<option>FL</option>
<option>GA</option>
<option>HI</option>
<option>ID</option>
<option>IL</option>
<option>IN</option>
<option>IA</option>
<option>KS</option>
<option>KY</option>
<option>LA</option>
<option>ME</option>
<option>MD</option>
<option>MA</option>
<option>MI</option>
<option>MN</option>
<option>MS</option>
<option>MO</option>
<option>MT</option>
<option>NE</option>
<option>NV</option>
<option>NH</option>
<option>NJ</option>
<option>NM</option>
<option>NY</option>
<option>NC</option>
<option>ND</option>
<option>OH</option>
<option>OK</option>
<option>OR</option>
<option>PA</option>
<option>RI</option>
<option>SC</option>
<option>SD</option>
<option>TN</option>
<option>TX</option>
<option>UT</option>
<option>VT</option>
<option>VA</option>
<option>WA</option>
<option>WV</option>
<option>WI</option>
<option>WY</option>
</select></td>
<td>Credits earned</td>
<td><input type="text" size="3" maxlength="3" name="College3Credits"></td>
</tr>
<tr>
<td colspan="2"><input type="radio" name="FallStart" value="Yes">I hope to start
in Fall term <select name="year" size="1">
<option>2000</option>
<option>2001</option>
</select></td>
<td colspan="2"><input type="radio" name="SpringStart" value="Yes">I hope to
start in Spring term <select name="D1" size="1">
<option>2001</option>
<option>2002</option>
</select></td>
</tr>
<tr>
<td colspan="4">Have you ever been convicted
of a felony? Yes <input type="radio" name="Felony" value="Yes"> No <input type="radio" name="Felony" value="No"></td>
</tr>
<tr>
<td colspan="4">Relatives who have attended
Sheldon Jackson College (if any):</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="3"><input type="text" size="35" maxlength="256" name="Relatives1"></td>
</tr>
<tr>
<td colspan="4">How did you first hear about
SJC?</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="3"><input type="text" size="49" maxlength="256" name="Firstcontact1"></td>
</tr>
<tr>
<td colspan="4">What is the most important
reason you are applying to SJC?</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="3"><input type="text" size="49" maxlength="256" name="Firstreason"></td>
</tr>
<tr>
<td colspan="4">What is the second most
important reason you are applying to SJC?</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="3"><input type="text" size="49" maxlength="256" name="Secondreason"></td>
</tr>
<tr>
<td colspan="4">Which academic program do you
intend to pursue at Sheldon Jackson College?
(Choose up to three)</td>
</tr>
<tr>
<td colspan="4"><select name="ChoiceOne" size="1">
<option selected>Choice Number One</option>
<option>Aquatic resources (aquaculture, fisheries, marine biology)</option>
<option>Business administration</option>
<option>Elementary education</option>
<option>Secondary education (language arts, math/science, social science)</option>
<option>Interdisciplinary studies</option>
<option>Natural resources (natural resource management, outdoor recreation)</option>
<option>Liberal arts (art, English, history, humanities, human services, social science, psychology, pre-law)</option>
<option>Undecided</option>
</select></td>
</tr>
<tr>
<td colspan="4"><select name="ChoiceTwo" size="1">
<option selected>Choice Number Two</option>
<option>Aquatic resources (aquaculture, fisheries, marine biology)</option>
<option>Business administration</option>
<option>Elementary education</option>
<option>Secondary education (language arts, math/science, social science)</option>
<option>Interdisciplinary studies</option>
<option>Natural resources (natural resource management, outdoor recreation)</option>
<option>Liberal arts (art, English, history, humanities, human services, social science, psychology, pre-law)</option>
<option>Undecided</option>
</select></td>
</tr>
<tr>
<td colspan="4"><select name="ChoiceThree" size="1">
<option>Choice Number Three</option>
<option>Aquatic resources (aquaculture, fisheries, marine biology)</option>
<option>Business administration</option>
<option>Elementary education</option>
<option>Secondary education (language arts, math/science, social science)</option>
<option>Interdisciplinary studies</option>
<option>Natural resources (natural resource management, outdoor recreation)</option>
<option>Liberal arts (art, English, history, humanities, human services, social science, psychology, pre-law)</option>
<option>Undecided</option>
</select></td>
</tr>
<tr>
<td colspan="4">What kind of campus housing
will you need?<dl>
<dt>&nbsp;</dt>
<dt><input type="radio" name="housing" value="Single">Single<br>
<input type="radio" name="housing" value="Family">Family<br>
<input type="radio" name="housing" value="None">None</dt>
</dl>
</td>
</tr>
<tr>
<td colspan="4">Enter any questions or
comments in the space provided below:</td>
</tr>
<tr>
<td colspan="4"><textarea name="Comments" rows="10" cols="70"></textarea></td>
</tr>
<tr>
<td colspan="4">There is a $25 fee for
applying to Sheldon Jackson College. We will
contact you after you complete this form.</td>
</tr>
<tr>
<td colspan="4">We will need the following
documents: official high school transcript or
GED (if you have earned less than 16 college
credits). Official college transcripts (if
any).</td>
</tr>
<tr>
<td><input type="submit" value="Submit Form"></td>
<td><input type="reset" value="Clear Form"></td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
</table>
</dd>
</dl>
</form>
<p><br>
Copyright © 1999 [Sheldon Jackson College]. All rights reserved.<br>
Revised: <!--webbot bot="TimeStamp" s-type="EDITED" s-format="%B %d, %Y" startspan -->October 09, 2000<!--webbot bot="TimeStamp" endspan i-checksum="29967" -->. </p>
</body>
</html>