Guaranteed Admission Application

Most recent college or post-secondary school *

Start date *

End date *

Add second college?

Yes

Other college or post-secondary school attended 2

Start date school 2

End date school 2

Add third college?

Yes

Other college or post-secondary school attended 3

Start date school 3

End date school 3

Are you a member of Phi Theta Kappa? (If yes, please submit verification of your PTK membership)

Yes

Please list courses in progress at the time of this application. (Include course number and title)

High School (which you graduated from) *

Date of graduation

Are you employed?

Yes

Employment status

Full-time

Part-time

Your position

How long have you been in this position?

Your employer

Employer phone

Disciplinary History

1. Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct that resulted in a disciplinary action? These actions could include, but are not limited to: probation, suspension, removal, dismissal, or expulsion from the institution.

Yes

2. Have you ever been adjudicated guilty or convicted of a misdemeanor, felony, or other crime? [Note that you are not required to answer “yes” to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise ordered by a court to be kept confidential.] If you answered “yes” to either or both questions, please attach a separate sheet of paper that gives the approximate date of each incident, explains the circumstances, and reflects on what you learned from the experience.

Yes

Disciplinary Explanation

I hereby certify that all information stated on this application is complete and accurate, and understand that falsification or omission of previous schooling will result in disqualification or dismissal.

Signature

Date

Guaranteed Admission Application

About Us

College & Schools

Find It Fast

Other

Contact Us

Follow Suffolk