Bloomsburg University of Pennsylvania

Application for Admission

I am applying for admission to Bloomsburg University for:

I wish to enter as a/an (check all that apply):

freshman

Fall Year:

Spring Year:

Summer Year:

transfer

part-time

full-time

Check your application status or apply online at

www.bloomu.edu/admissions

Please check here if you are participating in the ACE program.

Section I: Personal Data (please print or type)

Last Name Maiden

First Name Middle

Legal Street Address

City/Town County

Freshman applicants should submit the following:

Completed, signed application form with $35 processing fee. Take the application form to your high school principal, headmaster or guidance counselor. That individualwill complete SectionII and submit the entire application with an official high school transcript to the Office of Admissions.

GED (if applicable) from issuing source.

Official SAT/ACT score (scores will be accepted on the high school transcript).

State Zip Code

I certify that I am a legal, permanent resident of Pennsylvania Country of Citizenship:

Daytime telephone ( )

E-mail Address

Social Security Number (optional)

Date of Birth Gender: Male Female

Person to be notified in emergency:

Telephone ( ) Where

did you hear about Bloomsburg University? (check all that apply)

Radio TV Billboard Stadium Display Internet Friends/family Other

Have you visited Bloomsburg University? Yes No

If yes, when?

Have you applied or attended Bloomsburg University before?

Yes No If yes, when?

Have any of your relatives attended Bloomsburg University? If so,

please indicate:

Have you served in the U.S. Armed Forces? Yes No

If yes, when?

(Resident aliens must submit a copy of I-94 Green Card)

Transfer applicants should submit: Completed, signed application form with $35 processing fee. Official high school transcript or GED and official transcripts from each college or university attended (must be sent directly by the issuing source, i.e., Registrar to Admissions). SAT/ACT scores are required if you have less than 24 completed credits or if you have been out of high school for less than two years. Medical imaging applicants with a rad-tech associate’s degree must submit all official transcripts plus a photocopy of license. RN to BSN applicants must also submit a copy of their RN license.

Readmit applications should apply online at www.bloomu.edu/admissions.

International applicants should apply online at www.bloomu.edu/admissions.

Please indicate all areas that apply to your military experience: Reservist National Guard _Retired Separated Have been deployed Currently deployed or serving on active duty (includes Guard & Reserves) Spouse/Dependent

Are you interested in Army or Air Force ROTC? Yes No

I plan to live....

Note: Freshmen must reside on

contact the Office of Residence Life for

Activities

Check the appropriate space for high school or previous college activities in which you participated and indicate those activities in which you plan to participate at Bloomsburg University.

HS/ College BU

1. dramatics

2. debate

3. choral groups

4. band

5. flag corps

6. orchestra

7. majorette

8. yearbook

9. school paper

10. baseball

11. tennis

12. football

13. track

14. basketball

15. cross country

16. soccer

17. softball

18. wrestling

19. volleyball

20. swimming

21. radio/TV

22. cheerleading

23. field hockey

24. lacrosse

25. chess

26. Army/Air Force ROTC

27. class officer

28. student government

29. social fraternity

30. honors

31. Hugh O’Brian Youth

32. Partnership student

33. Upward Bound

34. Thos. Jefferson PACE

35. Make a Difference

Educational data (please print or type)

Name of high school presently attending or last attended:

Phone: ( )

Address County

City State Zip

When will/did you graduate? H.S. College Board code number

I took: SAT ACT Month/Year / I plan to take SAT ACT Month/Year /

For freshman applicants only From the Curriculum Codes section, indicate the area to which you seek admission. Select the two programs that interest you most within the area that you designate and record your choices in the spaces provided. This information is for planning and advisement purposes. It is not a guarantee that you will be permitted to enroll in one of the specific programs.

Program Description Program Code

Program Description Program Code Optional pre-professional advisement areas (must also select a major):

For transfer applicants only From the Curriculum Codes section, indicate the area to which you seek admission.

Program Description Program Code

Program Description Program Code

List ALL colleges you have attended (last institution first):

A. Name:

Dates of attendance CEEB Code

B. Name:

Dates of attendance CEEB Code

C. Name:

Dates of attendance CEEB Code

Are you now attending the institution listed on line A? Yes No It is your responsibility to see that an official transcript from each of the above-named institutions, as well as your high school transcript, are sent to the Bloomsburg University Admissions Office. To be considered official, transcripts must be sent by issuing source, i.e., high school guidance office, college registrar, etc.

Are you eligible for readmission to the last college you attended? Yes No

If no, was the dismissal Academic Social. Explain circumstances:

For all applicants Bloomsburg University is required by the U.S. Department of Education, Office of Civil Rights, to collect and report information pertaining to ethnic backgrounds of applicants for admission. This information will not affect the admissions decision. Mark an X in the boxes that apply to you: What is your ethnicity? Hispanic or Latino Not Hispanic or Latino

What is your race? Mark one of more races to indicate what you consider yourself to be.

White Black or African American

Asian American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

Curriculum Codes Turn to back page to sign your application; high school counselor must complete section on back

College .......Program Description...........................................................................Program Code

UCOB ..........Undergraduate College of Business ....................Bus Admin*Accounting BSBA................................................................. ACCTG-BSBA

....................Bus Admin*Finance BSBA...................................................................... FINAN-BSBA

....................Bus Admin*Info & Technology Management BSBA.................................. ITM-BSBA …………………Bus Admin*International Business BSBA……………………………………………….IB-BSBA

....................Bus Admin*Management BSBA.............................................................. MGMNT-BSBA

....................Bus Admin*Marketing, Professional Selling ............................................ MKSEL-BSBA

....................Bus Admin*Supply Chain Management .................................................. MTSCM-BSBA

....................Bus Admin*Marketing BSBA................................................................... MKTNG-BSBA

....................PTE*Business Education (teaching business subjects at K -12 levels) .... PTEBUSED

UCOED ........Undergraduate College of Education ....................ASL/English Interpreting BS .................................................................... ASL-BS

....................PTE*Early Childhood(PK-4) ………………………..s.........................................PTEPK-4

....................PTE*Mid Level*Lang Arts (4-8) ............................................................. PTEMLLANG

....................PTE*Mid Level*Math (4-8) .................................................................... PTEMLMATH

....................PTE*Mid Level*Science (4-8) ................................................................ PTEMLSCI

....................PTE*Mid Level*Soc Studies(4-8) ........................................................... PTEMLSOCST

....................PTE*Sec Ed*Biology .............................................................................. PTESEBIO

....................PTE*Sec Ed*Citizenship (History) .......................................................... PTESECIT

....................PTE*Sec Ed*Earth and Space Science ................................................... PTESEESS

....................PTE*Secondary Ed*Chemistry .............................................................. PTESECHEM

....................PTE*Secondary Ed*Comm ..................................................................... PTESECOMM

....................PTE*Secondary Ed*English.................................................................... PTESEENG

....................PTE*Secondary Ed*French..................................................................... PTESEFRE

....................PTE*Secondary Ed*German................................................................... PTESEGER

....................PTE*Secondary Ed*Mathematics........................................................... PTESEMATH

....................PTE*Secondary Ed*Physics ............................................................... PTESEPHYS

....................PTE*Secondary Ed*Spanish .................................................................. PTESESPA

....................PTE*Spec Ed(K-8)/Early Child(PK-4)...................................................... PTESEECK4

....................PTE*Early Childhood (PK-4)/Deaf and HOH (PK-12)............................... PTEPK4DHH

UCOLA ........Undergraduate College of Liberal Arts ....................Anthropology *Applied BA ...................................................................... ANTAPP-BA

....................Anthropology *General BA ...................................................................... ANT GEN-BA

....................Anthropology * Research BA................................................................... ANTRES-BA

....................Art History BA......................................................................................... ARTHIST-BA

....................Art Studio BA.......................................................................................... ARTSTU-BA

....................Art Studio BA*Drawing ........................................................................... ARTSTD-BA

....................Art Studio BA*Fabric Design................................................................... ARTSTFD-BA

....................Art Studio BA*Graphic Print Design ....................................................... ARTSTPD-BA

....................Art Studio BA* Graphic Web Design........................................................ ARTSTWD-BA

....................Art Studio BA*Painting ........................................................................... ARTSTP-BA

....................Art Studio BA*Photography..................................................................... ARTSTPH-BA

....................Art Studio BA*Printmaking ..................................................................... ARTSTPR-BA

....................Art Studio BA*Sculpture ......................................................................... ARTSTS-BA

....................Comm Studies*Interpersonal Comm BA ................................................. COMSTIR-BA

....................Comm Studies*Leadership & Public Advocacy BA .................................. COMSTLP-BA

....................Comm Studies*Organizational Comm BA ............................................... COMSTOC-BA

....................Criminal Justice BA................................................................................. CRIMJUS-BA

…………………Digital Rhetoric & Professional Writing Certificate………………………………………..DRPW-CERT ....................Economics*Business BA ........................................................................ ECONBUS-BA

....................Economics*General BA .......................................................................... ECONGEN -BA

....................Economics*Political Economics BA ........................................................ ECONPOL-BA

....................English*Creative Writing BA ................................................................... ENGCW-BA ...................English*Digital Rhet & Prof Writing BA...................................................ENGDRPW-BA

....................English*Literature BA............................................................................. ENGLIT-BA

....................History BA .............................................................................................. HISTORY-BA

....................Interdisciplinary Studies BA*Advanced Studies ...................................... INTERAS

....................Interdisciplinary Studies BA*University Studies ..................................... INTERUS

....................Languages and Cultures*Arabic BA........................................................ LNGCLTA-BA

....................Languages and Cultures*Chinese BA ............................................. ........ LNGCLTC-BA

....................Languages and Cultures*French BA ....................................................... NGCLTF-BA

College .......Program Description......................................................................... Program Code

UCOLA ........Undergraduate College of Liberal Arts, contd. ....................Languages and Cultures*German BA ..................................................... LNGCLTG-BA

....................Languages and Cultures*Russian BA ..................................................... LNGCLTR -BA

....................Languages and Cultures*Spanish BA ..................................................... LNGCLTS -BA

....................Mass Comm*Emergent Media BA........................................................... MCOMMEM-BA

....................Mass Comm*Journalism BA................................................................... MCOMMJ-BA

....................Mass Comm*Public Relations BA ...........................................................MCOMMPR-BA

....................Mass Comm*Telecommunications BA .................................................... MCOMMTC -BA

....................Music Education Cert K-12 BA................................................................ MUSICED-BA

....................Music Liberal Arts BA ............................................................................. MUSICLA-BA

....................Music*Audio Video Record BA ................................................................ MUSICAV-BA

....................Philosophy BA......................................................................................... PHIL-BA

....................Political Science BA ................................................................................ POLISCI-BA

....................Pol Sci*Legal Studies Opt BA ................................................................. PSLSO -BA

....................Pre-Social Work...................................................................................... PRESOCWORK

....................Psychology BA ........................................................................................ PSYCH-BA

....................Sociology BA........................................................................................... SOC -BA

....................Sociology BA*Applied ............................................................................ . SOCAS-BA

....................Theatre Arts*Set Design BA.......................................................................... THTARTD-BA

....................Theatre Arts*Integrated BA..................................................................... THTARTI-BA

....................Theatre Arts*Performance BA................................................................. THTARTP-BA

....................Undeclared ............................................................................................. UNDECLARED

UCOST ........Undergraduate College of Science & Technology ....................Biology BA .............................................................................................. BIO-BA

....................Biology BA*Natural History..................................................................... BIONH-BA

....................Biology BS .............................................................................................. BIO-BS

....................Biology*Environment Biology BS ............................................................ BIOENV-BS

....................Biology*Molecular Biology BS................................................................. BIOMOLE-BS

....................Biology*Pre-Medical Science BS ............................................................ BIOPMED-BS

....................Chemistry BA ......................................................................................... CHEM-BA

....................Chemistry BS ......................................................................................... CHEM-BS

....................Chemistry*Biochemistry BS ................................................................... CHEMBIO-BS

....................Chemistry*Nanotechnology BS............................................................... CHEMNAN-BS

....................Digitial Forensics BS ............................................................................... DIGFOR-BS

....................Computer Science BS ............................................................................. COMPSCI-BS

....................Electrical Engineering Technology BS………………………………………………………..EETECH-BS ………………….Environ., Geograph. & Geology* Professional Geology BS ........................... EGGSPG-BS

....................Environ., Geograph. & Geolog.*Environmental Geosci BS........................ EGGSENVGEO-BS

....................Environ., Geograph. & Geolog.*Geography & Planning BS ....................... EGGSGEOPLAN-BS

...................Exercise Science BS ............................................................................... EXSCI-BS ....................Health Physics BS................................................................................... HLTHPHY-BS

....................Health Sciences*General BS .................................................................. HSGEN-BS

....................Health Sciences*Medical Lab Science BS............................................... HSMLS-BS .................Health Science*Pre-Nursing 2nd degree accel BS.......................................HSPNURS-BS ................Health Science*Pre-Pharmacy BS...............................................................HSPPHAR-BS

....................Health Sci*Pre-Physician Assistant BS .................................................. HSPPA-BS ....................Health Sci*Pre-Physical Therapy BS ....................................................... HSPPT-BS ......................Mathematics BA ................................................................................... ... .......... MATH-BA ....................Mathematics Statistics BA...................................................................... MATHSTA-BA ....................Mathematics BS .................................................................................... MATH-BS .................Medical Genomics & Counseling Certificate.................. ……………………….MEDGC-CERT

....................Medical Imaging BS................................................................................ MEDIM-BS ....................Nursing BSN........................................................................................... NURS-BSN ....................Nursing Licensed RN-BSN ...................................................................... NURS-RNBSN ....................Physics BA ............................................................................................. PHYSICS-BA ....................Physics BS ............................................................................................. PHYSICS-BS ………………..Pre-Med Sci Certificate………………………………………………………………………..PREMD-CERT ....................Science & Technology Undeclared........................................................... STUNDECLAR ....................Speech Path & Audiology BS................................................................... SPPATH-BS

....................Technical Leadership BAS....................................................................... TECHLEA-BAS

All applicants: affidavit Have you ever been convicted of a felony offense? ______Yes ______No

If yes, please explain*:_________________________________________________________

____________________________________________________________________________

_____________________________________________________________________________

*A conviction is an adjudication of guilt and includes pleas of nolo contender (no contest). Pleasedisregard minor traffic violations, offenses committed before your 18th birthday, which wereadjudicated in juvenile court under a Youth Offender Law, and any charges which have beenexpunged by a court or for which you successfully completed an Accelerat4ed RehabilitativeDisposition Program.

*A “yes” answer will be reported to the Pennsylvania Higher Education Assistance Agency (PHEAA)if the applicant receives PHEAA aid. A “yes” answer will not necessarily bar admission to theUniversity, but it may limit the ability to enroll in or complete certain academic majors/programs,and may affect approval to live in university-owned or university-affiliated housing.

I certify the above statements are correct and that I have answered all applicable questions. I understand that any falsification of the above information may invalidate my application. Further, my signature indicates my approval for the Admissions Office to discuss information about my application with the guidance personnel at my secondary school or college (if applicable)

Signature of applicant Date

Signature of parent or legal guardian is required, if applicant is under 18 years:

Date

Section II - High School (To be completed by high school counselor, if you are currently enrolled in high school.)

The applicant should have completed Section I. Please complete Section II and submit the entire application and an official transcript of secondary school work to:

Pertinent remarks about the candidate’s qualifications and character are invited. Attach additional sheets, as necessary.

This applicant is is not a candidate for the EOP or ACT 101 program.*

*Please submit documentation to support candidacy.

Name

Signature Phone

Title Date

Bloomsburg University does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, age, national origin, ancestry, disability, or veteran status in its programs and activities as required by TitleIX of the Educational Amendments of 1972, the Americans with Disabilities Act of 1990, Section 504 of the Rehabilitation Act of 1973, TitleVII of the Civil Rights Act of 1964, and other applicable statutes and University policies.

Frequently asked questions:

How soon will I hear about my completed application?

Admissions reviews your application within two to four weeks of its completion, and notifies you by regular mail of its decision. You may also check your application status online at www.bloomu.edu/admissions.

How early can I apply for admission? You can apply at any time, but applications for the following fall begin to get consideration in September of what would be your senior year in high school. We do not ask students to take SAT or ACT tests as juniors, but we do require SAT or ACT scores for consideration of application, so it is a good idea to take them early in the senior year.

What is your application deadline? You can apply at any time, however, you should apply by December 1 for the best consideration. For all majors, with the exception of nursing, we will notify you of a decision within two to four weeks of receiving a completed application. For freshman, nursing applicants, decisions will be made around the end of November/early December. For some majors, applications received past December 1 will be considered late. We also welcome applications from transfer students in good standing, as well as international and non-traditional students. Freshmen nursing applicants must apply by Nov. 15 and transfer, nursing students by March 1.

When can I come for a visit?

Group presentations are held throughout each week, including select Saturdays, and are followed by a campus tour. Individual interviews can be made based on availability. Please register for a visit at www.bloomu.edu/admissions.

Open House Programs: You can register after September 1 online (www.bloomu.edu/admissions).

Learn more about BU at www.bloomu.edu.

Mailing Address: Office of Admissions Bloomsburg University 104 Warren Student Services Center 400 East Second Street Bloomsburg, PA 17815-1301

Questions? Contact us at buadmiss@bloomu.edu or at 570-389-4316.