Adrian College

Adrian College - Application for Enrollment

PLEASE READ:
If you prefer to print, fill out, and mail an application, please download our printable application and follow instructions.

If you are an international student (except Canadians, click here), a non-traditional student, a re-entering student or a non-degree-seeking student, please contact the Admissions Office for the appropriate application. 1-800-877-2246. If you are an applicant for Operation Education, please click here for a printable application.

Personal Information

First Name:
Last Name:
Preferred Name:
Address:
City:
State:
ZIP:
Home Phone:
E-mail:
Social Security Number:

I am a U.S. Citizen
I am a permanent US Resident
Date of Birth (MM/DD/YYYY):
Sex:
Marital Status

Optional Information

Race	Asian White Hispanic/Latino
please check	Native Hawaiian or Other Pacific Islander
all that apply	Black or African American
	American Indian or Alaska Native
Religious Preference

Family Information

I live with:
Father's/Stepfather's/Guardian's Name
Address (if different)
College Attended
Degree Obtained
Employer
Occupation
Work Phone
E-mail Address
Mother's/Stepmother's/Guardian's Name
Address (if different)
College Attended
Degree Obtained
Employer
Occupation
Work Phone
E-mail Address
Brothers and Sisters currently attending college:
Name:	College:
Name:	College:
Relatives or friends who have attended or are attending Adrian College:
Name:
Relationship: Attending Attended
Name:
Relationship: Attending Attended

Academic Information

Top Choice Major #1
Top Choice Major #2
I plan to enter in:
I am applying as a:
I plan to live:

High School Information

High School Name:
Graduation Year
Public or Private School?
Address:
City:
State:
ZIP:
Name of Guidance Counselor
His/Her Office Phone Number:
His/Her Office Fax Number:

College Information

Colleges attended (if any):
College most recently attended:
Date attended:
Degrees earned:
Total transfer hours completed:
Total transfer hours now enrolled:
Cumulative GPA
Anticipated GPA

Test Record

I have taken the ACT
I have taken the SAT
I will retake the ACT		Date
I will retake the SAT		Date
I have passed the MEAP test
The ACT College Code for Adrian is #1954. The SAT College Code is #1001

Personal Interests

Varsity Sports Played	Football	Baseball	Soccer
	Softball	Basketball	Volleyball
	Golf	Cheer/Dance	Track/Cross Country
	Tennis	Other :

Cocurricular	Newspaper	Radio	Marching Band
	Theatre	Choir	Student Government
	Yearbook	Other:

Student Organizations	Community Service	Honors Society	Foreign Language
	Religious Life	Other:

Financial Aid Information

I plan to apply for Financial Assistance
If yes, you must file the Free Application for Federal Student Aid (FAFSA) between January 1 and February 15 for maximum consideration. The code for Adrian is 002234
I hold a Michigan Educational Trust Contract (MET)

By pressing "Submit" you are hereby authorizing your high school to provide transcripts and test scores to Adrian College.

I certify that the information given on this application is complete and accurate to the best of my knowledge. I understand that all documents submitted become the property of Adrian College. I understand that the misrepresentation of information on this form could render me subject to immediate dismissal from the College.


SEARCH	ADRIAN COLLEGE \| 110 S. Madison St. \| Adrian, MI 49221 ADMISSIONS: 1-800-877-2246 \| Switchboard: 517-265-5161	MY ADRIAN


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