Summer Quick Admit Form

CLARION UNIVERSITY OF PA

Summer Quick Admit Form
 

The quick admit policy limits undergraduate students to a total of 12 credits. If a student wishes to continue coursework beyond 12 credit hours,
he or she must seek admission to the University through the Admissions Office. Graduate students should contact the Division of Graduate Studies
at 814- 393-2337.

Please complete the top portion of the form completely.  Use N/A for items that do not apply.   Items with an * are required entries.

Last Name*:
First Name*
Middle Initial: 
Former Names: 
Street Address*:
City*:
State*: Zip*:
Email Address: 

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Birthdate:  (MM/DD/YYYY)
Sex: Select M F       Race:    Select White, Non-hispanic Asian or Pacific Islander Black, Non-Hispanic Hispanic American Indian/Alaska Native Prefer not to answer

Daytime Phone Number:
Home Phone Number*:

PA Resident*: Select Yes No
If yes, name of county:

Status*: Freshman Transfer Transient/Guest
Campus Choice*:  Clarion  Venango  Online        Pittsburgh 

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High School Attended:
Dates Attended:
High School City and State
GED: Select Yes No
If GED earned, date GED was received:
Have you attended Clarion University previously?* Select No Yes

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If your are a transfer or transient/guest student please list the following;
Full Name of College Name (no abbreviations please):
Degree/QPA:
College Attendance Dates:

Term for which you are applying*:	Pre-Session	Year*:
(Check as many as applicable.)	Summer I
	Summer II

Number of credits  you wish to attempt this summer*:

How did you hear about Summer Quick Admit? Please Select Clarion Website Email Direct Mail Telephone Friend, relative, or colleague Newspaper Search Engine (i.e. Google) Professional Organization Affiliation Other

By clicking the submit button, you are verifying that the information provided is accurate.