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1 application for admission

2 We are excited that you are applying for admission to! To ensure a timely response, please submit all required documentation with your application to: Office of Admission 1000 Rim Drive Durango, CO Admission classifications > Freshman A student who is enrolling in college for the first time since graduating from high school. > Transfer A student who is currently or has previously enrolled at another college or university for one or more courses since graduating from high school. > Returning A student who has previously applied to or attended Fort Lewis College. Application procedures > TYPE or PRINT neatly in BLACK ink. Answer questions completely on all pages of the application. Do not use nicknames. > Attach a $40 non-refundable check or money order. Please note applicant s name and date of birth on check. > In submitting your official transcripts, please use the following address: Office of Admission 1000 Rim Drive Durango, CO Guidelines for specific admission classifications Freshman Applicants > Send a completed application and $40 application fee to the Office of Admission & Advising. > Request your high school transcripts* or GED certificate be sent directly to the Office of Admission & Advising. > Have your official ACT and/or SAT scores sent directly to the Office of Admission & Advising. Transfer Applicants > Send a completed application and $40 application fee to the Office of Admission & Advising. > Have an official transcript* from ALL colleges and universities attended mailed directly to the Office of Admission & Advising. > High school transcripts and official ACT and/or SAT scores also must be provided if you have completed fewer than 30 semester hours at another college or university. Re-Admit Students > Send a completed application and $40 application fee to the Office of Admission & Advising. > Have an official transcript* from ALL colleges and universities attended (except Fort Lewis College) mailed directly to the Office of Admission & Advising. unclassified Students > Send a completed application and $40 application fee to the Office of Admission & Advising. > Note: Unclassified students are non-degree seeking and must be at least 20 years of age. * A transcript is considered official ONLY if it is provided DIRECTLY from the originating school to. Deadlines FEBRUARY 15 FEBRUARY 15 Priority deadline for Free Application for Federal Student Aid FLC Foundation scholarship application > In submitting your test scores, please use the following institution codes: ACT (0510); SAT (4310); TOEFL (4310). > Complete the free application for financial aid (FAFSA) at MAY 1 AUGUST 15 AUGUST 31 Enrollment confirmation Fall Semester Admission Deadline First day of classes! 22

3 APPLICATION FOR ADMISSION A non-refundable application fee of $40 MUST accompany this application. Please type or print in black ink. ENTRY INFORMATION for which academic term are you applying? r Spring 2015 (begins January 2015) r Summer 2015 r Fall 2015 (begins August) r Spring 2016 (begins January 2016) your admission classification r Freshman Student r Transfer Student r Returning Student r Unclassified Student r Guest Student Durango, Colorado have you previously applied to fort lewis college? r Yes r No If yes, when? have you previously attended fort lewis college? r Yes r No If yes, when? ACADEMIC INTEREST For a complete listing, please see the back page of this application. Note: this section is non-binding. What will be your proposed major(s) or field(s) of study? First choice Second choice r Undecided What is your educational goal at? r Bachelor s Degree r Teaching Certificate r No Degree to which other colleges or universities are you applying? PERSONAL INFORMATION Full Legal Name / Last First middle Name under which transcript(s) will be submitted Social Security No. Birthdate / / Age rmale rfemale For record-keeping purposes only Month Day Year Home Address Number and Street City State Zip Address cell PHONE( ) Address to which admission information should be sent (Notify promptly if it changes) contact PHONE( ) Number and Street City State Zip Willing to recieve text messages from FLC r Yes r No Nation of Citizenship If not a U.S. citizen, provide temporary visa number Expiration Date Attach a photocopy of visa. If a permanent U.S. resident, provide alien registration number Date of Issuance Attach a photocopy of both sides of permanent registration card. Military Service r Yes r No If yes: Active Duty Dates / to / Are you eligible for veterans benefits? r Yes r No CONDUCT STATEMENT Although checking yes does not automatically deny you admission, you must answer the following question and provide the requested information for the timely processing of your application. Have you ever been convicted of or are any charges pending against you involving any felony criminal offense or any misdemeanor assault or sexual offense? r Yes r No Convicted means the entry of a plea of guilty, nolo contendere or Alford, or a verdict or finding of guilt, including cases where no sentence was imposed on you (for example, if you received a deferred judgment or sentence). If you checked yes, please state for each conviction and pending charge the nature, date and location of the offense or alleged offense, the date of the conviction or the status of the charge, and the name of the court in which your case was heard or is pending. 3

4 Ethnicity and race information 1. Are you of Hispanic, Latino or Spanish origin? r Yes r No 2. Which race(s) describe you? (Note: You may select more than one race.) A. American Indian or Alaska Native r Yes r No D. Native Hawaiian or Other Pacific Islander r Yes r No B. Asian r Yes r No E. White r Yes r No C. Black or African American r Yes r No SELECTIVE SERVICE To comply with Colorado state law, all males between the ages of 17 years and 9 months and 26 years must answer the following question: Are you registered with the selective service? r Yes r No FAMILY INFORMATION Please complete the following information for your parent(s) or legal guardian(s). If you are over the age of 23, you may skip this section. Name relationship Street Address City/State/Zip home phone ( ) Work ( ) address Name relationship Street Address City/State/Zip home phone ( ) Work ( ) address Did either parent/guardian receive a bachelor s degree from any college or university? r Yes r No SECONDARY EDUCATION Type of School r Public r Parochial r Private r International last high school attended Name City State Zip Dates of attendance (mo/yr) / to / Have you earned, or will you earn, a ged certificate? r Yes r No Date of high school graduation (mo/yr) / if yes: DatE (mo/yr) / State or Agency when did you take, or plan to take, college entrance exam(s): ACT (mo/yr) / ACT (mo/yr) / ACT (mo/yr) / SAT (mo/yr) / SAT (mo/yr) / SAT (mo/yr) / COLLEGE EDUCATION List ALL colleges you have attended, are currently attending, or plan to attend before enrolling at. Include college(s) where course work was completed through correspondence or extension. Please attach an additional sheet of paper if needed. If you have not previously attended, you do not need to include Fort Lewis in your response. No part of the previous collegiate record may be disregarded. Any coursework taken at any type of higher education institution including community colleges, vocational-technical institutes or non-accredited colleges must be listed. Failure to list all previously attended institutions is a serious offense that may result in the rescinding of admission, loss of credit, or disenrollment. Official transcripts of all collegiate work attempted are required. Transcripts must show all work attempted from each institution attended. Although course work taken at vocational-technical institutes or non-accredited colleges may not transfer, these official transcripts are still required. NAME OF COLLEGE OR UNIVERSITY CITY/STATE/Zip dates OF ATTENDANCE DEGREE / DATE EARNED TO / TO / TO / TO / Request each college you ve attended to send an official transcript to. When courses in progress are completed, have final transcript(s) sent. Transfer applicants who have completed fewer than 13 semester hours must also submit high school transcripts and ACT and/or SAT scores. Have you previously taken or are you currently taking college-level classes through a dual-enrollment/concurrent enrollment program? r Yes r No (If yes, please list the institution and the dates in the fields above.) 4 ARE YOU ELIGIBLE TO RETURN TO ALL COLLEGIATE INSTITUTIONS PREVIOUSLY ATTENDED? r Yes r No (If no, please attach a statement of explanation.)

5 APPLICATION FOR ADMISSION academic preparation Please complete the following section on your academic preparation. Note: this section is mandatory to complete and an application cannot be reviewed until it has been completed. By the time of enrollment, will you have successfully completed full academic years Of high school or college IN: English - 4 years r Yes r No Social Studies - 3 years r Yes r No Should include at least 1 year of US History or World History. Math - 4 years r Yes r No Must be Algebra I or higher. Foreign Language - 1 year r Yes r No Science - 3 years r Yes r No Should include at least 2 years of lab-based coursework. Academic Electives - 2 years r Yes r No Courses may come from any academic area already listed or foreign languages, computer science, art, music, journalism, or drama. IN-STATE TUITION ELIGIBILITY Only complete if you are claiming in-state tuition If you are claiming eligibility for the in-state tuition rate, please answer the following questions. State law requires you to provide proof of your presence in Colorado, and these questions help us to determine your eligibility for the in-state tuition rate. 1. Are you claiming eligibility for in-state tuition? r Yes r No 2. Are you a U.S. citizen? r Yes r No 3. Did you or will you graduate from a Colorado public or private high school? r Yes r No 4. Did you attend a Colorado high school for at least three consecutive years? r Yes r No 5. will you have resided in Colorado for the three years immediately preceding r Yes r No your proposed first semester of enrollment at? If you answered YES to all of the questions, you may skip the next section. If you answered NO to any of the questions OR you are a GED student, please complete the next section. Only complete if aswered no above and you are claiming in-state tuition Colorado county of residence Dates of continuous physical presence in Colorado Date Colorado driver s license was first issued Date current Colorado driver s license was issued List the years your vehicle has been registered in Colorado Date of Colorado voter registration Are you currently registered to vote in Colorado? Date of purchase or lease of Colorado residential property Dates of military service, if applicable Have you filed a Colorado State Income Tax Return? If parents are separated or divorced, which one lives in Colorado? Dates of extended absence from Colorado (more than one month) Reason for absence Date of marriage, if applicable Dates of employment in Colorado Parent info (if you are under age 23) r 2012 r 2013 r 2014 r 2015 r Yes r No r 2012 r 2013 r 2014 r 2012 r 2013 r 2014 r 2015 STUDENT info (if you are OVER age 23) r 2012 r 2013 r 2014 r 2015 r Yes r No r 2012 r 2013 r 2014 r 2012 r 2013 r 2014 r 2015 signature By completing and submitting this application, I indicate that all of the information given is correct to the best of my knowledge. I understand that furnishing false information may result in disciplinary action by or revocation of the offer of admission. I also understand my continuing obligation to report any changes to my application between now and the time of enrollment, within 30 days of occurrence. Applicant s signature Date If applicant is under 18 years of age, a parent or guardian s signature is also required. Parent/guardian s signature Date 5

6 ADMISSION INDEX FOR FRESHMeN To calculate your CCHE Index you must add together your Index points. The first set of points is determined by your standardized test scores (dark blue bars on the left). The second set of points is determined by your overall GPA (GPA is the dark blue bar along the top. Note: SAT scores reflect only Critical Reading and Mathematics; the Writing portion is not included in the index computation. 91 Index and below: Possibly admissible Contact Admission for details 92 Index & higher: Admissible 95 Index and higher: Admissible; eligible for a merit scholarship TEST SCORES OVERALL GPA (ON A 4.0 SCALE) GPA ACT SAT INDEX Students without an index score are ineligible for the following Fort Lewis Merit Scholarships. Freshman* Scholarship scale Index score In-state Out-of-state 121 & above $5,000 $9,000 * $4,000 $8,000* $3,000 $6, $2,000 $4,000 transfer* Scholarship scale Cum. GPA In-state Out-of-state 3.5+ $2,000 $3, $1,500 $2,500 * Equal or greater to the Western Undergraduate Exchange tuition discount. 6

7 APPLICATION FOR ADMISSION letter of recommendation Part I: Student Information (to be completed by the student) Name Last First middle Birthdate / / address I am applying for (check one) r Spring 2014 r Summer 2014 r Fall 2014 r Spring 2015 By signing below, I waive the right to review this letter of reference. I understand that this recommendation is confidential and will not be released to me or to any third party. Signature Date Part II: Counselor or Teacher (to be completed by the recommender) This student is applying for admission to. We seek comments and appraisals of each applicant s character, intellectual aptitude, motivation, maturity and personal qualities. We encourage you to be as candid as possible in your evaluation as this assessment will play an invaluable role in our review process. We encourage you to attach an additional sheet of paper to provide further comments. We thank you in advance for your assistance! recommender s Name school/organization title How long have you been in this role? mailing address city, state, zip CONTACT phone ( ) How long, and in what capacity, have you known this student? percentage of graduating class immediately attending Four-year Two-year institutions compared to other college bound students at your school, please evaluate the applicant s curriculum: r Rigorous r Demanding r Average r Below Average Please rate the applicant in the following areas: No basis Below average Average Top 25% Top 10% Top 1% Academic achievement Creativity Extracurricular accomplishments Independence Intellectual ability Potential for growth Readiness for college Written expression of ideas How familiar are you with? r Very familiar r Somewhat familiar r Not familiar at all Signature Date Please mail to: Office of Admission,, 1000 Rim Drive, Durango, CO

8 FIND A program that s perfect for you... MAJORS Contact us 1000 Rim Drive Durango, CO Admission FLC-COLO (toll-free) (fax) Athletics Disability Services El Centro Hispano Center Financial Aid Honors Program Housing Native American Center Registrar s Campus Security Report is available at edu/studenthandbook. This report includes College safety policies and statistics of crimes that occurred on or near campus. A paper copy of the report is available in Student Affairs, Room 230, Miller Student Services. does not discriminate on the basis of race, age, color, religion, national origin, gender, disability, sexual orientation, political beliefs, or veteran status. Accordingly, equal opportunity for employment, admission, and education shall be extended to all persons. Send inquiries to the Equal Opportunity Coordinator, Accounting Major Adventure Education Major* Anthropology Major Art Major Art Option Art K-12 Teaching Option* Business Art Option Graphic Design Option Athletic Training Major* Biology Major Biology for Secondary Teachers Option* Cellular and Molecular Biology Option Environmental and Organismic Biology Option General Biology Option Business Administration Major Business Administration Option Engineering Management Option Finance Option International Business Option Management Option Tourism and Hospitality management Option Chemistry Major Chemistry Option Biochemistry Option Chemistry for Secondary Teachers Option* Early Childhood Education Major* Elementary Education Major* Economics Major Economics Option Business Economics Option Engineering Major MINORS Forensic Studies Minor Rhetoric of Inquiry Minor* John F. Reed Honors Program Peace and Conflict Studies Minor Pre-Law Minor Religious Studies Minor English Major Communications Option English for Secondary Teachers Option* General Option Writing Option Environmental Studies Major Exercise Science Major Exercise Physiology Option Exercise Science K-12 Teaching Option* Exercise Specialist Option Sport Administration Option* Gender and Women s Studies Major Geology Major Environmental Geology Option Geology Option History Major General Option Public History Option Social Studies for Secondary Teachers Option* Interdisciplinary Studies Major Liberal Studies Major Marketing Major Mathematics Major General Option Mathematics for Secondary Education Option* Music Major* General Music Studies Option Jazz Studies Option Music Business Option Music K-12 Teaching Option* Music Performance Option Native American and Indigenous Studies Major Philosophy Major Physics Major Physics Option Engineering Physics Option Political Science Political Science Major Psychology Major Public Health Major Allied Health Option Environmental Health Option Psychosocial Option Sociology/Human Services Major Criminology Option Ethnic Studies Option General Option Spanish Major K-12 Teaching Option* Latin American Option Spanish Option U.S. Latino Studies Option Student Constructed Major Theatre Major Arts Administration Option Design and Technical Theatre Option Performance and Directing Option Secondary Drama Teaching Option* Theatre Generalist Option *These programs have specific admission criteria. Please visit catalog.fortlewis.edu for details. PRE-PROFESSIONAL PROGRAMS and certificates Pre-Health Pre-Medicine Cultural Resource Management Certificate Geographic Informations Systems Certificate

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