Online Application

high school last attended
ceeb code Search for High School CEEB code high school graduation date (month, year)
number and street
city state zip
telephone name of high school counselor

List all colleges and universities attended
(include part-time, summer attendance and dual enrolment)
Check here if dual enrolled
Name of	Academic	Cumulative	Degree	Financial
Institution	Years	GPA	Received	Aid Received
				Yes No
				Yes No
				Yes No
IMPORTANT NOTICE! Upon graduation from high school or completion of current college work, applicants must request an official high school or college transcript be sent to the Office of Admissions. CERTIFICATION OF INFORMATION/AUTHORIZATION TO USE: I affirm, on my honor, that the information submitted on this application is complete and accurate and, if admitted to Ferrum College, I will abide by the regulations, ideals and principles of the institution. By submitting this application, I also give permission for the release of all transcripts ( high school and college) to Ferrum College. Furthermore, I agree that my college grades may be used for statistical studies or sent to my high school or college for evaluation purposes.

Check here if paying the $25.00 Application Fee by credit card
Card Holder First Name:
Card Holder Last Name:
Card Holder Address:
Card Holder City:
Card Holder State:
Card Holder Zip:
Card Holder Phone:

Full Legal Name:
first middle last preferred

Home Address:
number and street
city state zip/postal code
county telephone
cell phone
e-mail address

Mailing Address: (if different from above)
number and street
city state zip
county telephone
Dates: from to

Gender: Male Female Veteran: Yes No
Date of Birth: Month Day Year Place of Birth: city state
Social Security Number:

I plan to be a: Entering as:
The year I plan to attend: Spring Semester Fall Semester

Names of relatives who attended Ferrum College:
name class relationship
name class relationship
name class relationship
name class relationship
name class relationship

Type of housing in which you will reside while attending Ferrum College:
(if other, specify)

U.S. Citizen: Yes No (if no, country of citizenship)
Type of Visa: F1 PA Other (specify)
Have you ever been convicted of a crime (felony or misdemeanor) in any state? Yes No If Yes, please enter an explanation including the nature, date, and location of the crime.
Have you ever been dismissed, suspended, or expelled from any high school or college? Yes No If yes please provide written details of the circumstances.
(optional) Are you of Hispanic or Latino origin? Yes No Choose not to answer Which of these categories best describe you? (optional) American Indian or Alaska Native Yes No Choose not to answer (optional) Asian Yes No Choose not to answer (optional) Black or African American Yes No Choose not to answer (optional) Native Hawaiian/Pacific Islander Yes No Choose not to answer (optional) White Yes No Choose not to answer
(optional) Religious affiliation: (if other, specify)
(optional) Name of Minister:
(optional) Name of Local Church:
(optional) If Methodist, are you a member of the Virginia Annual Conference? Yes No

Activity	Grade Level				Time Spent		Position held, honors won, or letters earned
	9	10	11	12	hrs/wk	wks/yr
School clubs, organizations, performance groups, etc.
(distinguish between vocal and instrumental music)





Community, church activities



Athletics





Work Experience


List clubs and sports you are interested in participating in at Ferrum College


About Your College Plans
Please indicate your probable major field of study if you have a preference at this time. If undecided, please check here
*Major (first choice):*
*Major (second choice):*
Other Colleges you are applying to:


Family Information
Name of Father Guardian Spouse:
street address
city state zip
occupation
place of employment
job title
Phone: (home) (work)
College(s) Attended graduation date

Name of Mother Guardian Spouse:
street address
city state zip
occupation
place of employment
job title
Phone: (home) (work)
College(s) Attended graduation date

Applicant lives with: (check all that apply)
Father Mother Stepfather Stepmother Spouse Other

Check if any apply
Father Deceased Mother Deceased Parents Separated Parents Divorced

To whom should Parent/Guardian information be sent:
name(s)
number and street
city state zip
telephone

Billing Address (if different from above)
number and street
city state zip
telephone