Application for Admission

Note:  In addition to filling out this form, the following is also required:


 

Admit Type:     Which semester will you be attending? 

Social Security Number (needed for IRS reporting)      Last Name      First Name     MI 

Address -    Street / P.O. Box    City     State     Zip 

Birthdate     Gender    U.S. Citizen?     -If NO, country of origin: 

Marital     Utah Resident?    - If Yes, dates of residence?   From     To 

Drivers License #     State    Telephone #     Ethnic Origin  

E-Mail Address    

What degree are you pursuing?      What is your desired major? 

High School Attended:     High School Graduation Date (month/year):

High School Location: 

Have you attended any colleges previously?  Please list the colleges, along with the dates of attendance, and whether you earned a degree

I certify that the above information is true and accurate to the best of my knowledge:      Today's Date: