APPLICATION FOR DUAL ENROLLMENT AND DUAL ADMISSION University of Oregon and Southwestern Oregon Community College

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1 APPLICATION FOR DUAL ENROLLMENT AND DUAL ADMISSION University of Oregon and Southwestern Oregon Community College APPLICATION INFORMATION This application is used to apply for admission to both University of Oregon (UO) and Southwestern Oregon Community College (SOCC). Submit the completed application to: Office of Admissions Dual Enrollment Coordinator 1217 University of Oregon Eugene, OR APPLICATION TERM AND DEADLINES UO fall term admission application deadline May 15 Please review the UO Office of Admissions web site <admissions.uoregon.edu> for other term deadlines. Current students at Southwestern Community College or the UO may be admitted for any term. Admission to some programs requires submission of an additional application or additional documents by an earlier deadline. For information on admission to specific programs, see the UO Office of Admissions web site <admissions.uoregon.edu> or contact SOCC Office of Admissions and Records. DUAL ENROLLMENT AND DUAL ADMISSION Students enrolled in the Dual Enrollment Program are usually enrolled for classes at the same time. Typically, this would be a student at UO who also has online classes from SOCC. Dual Admission students are enrolled at SOCC and have been admitted to UO before they complete their program of studies at SOCC. CO-ADMISSION CRITERIA Dual enrollment and dual admission is limited. Fulfilling minimum requirements does not guarantee admission to the Dual Enrollment and Dual Admission Program. Students with fewer than 24 transferable college credits must meet all UO admission requirements. STUDENT RECORD RELEASE As a condition of admission to this program, you must sign an agreement to release student record information to each institution. This allows SOCC and the University of Oregon to share your student record information so that you can easily move back and forth between the two institutions. EXTENUATING CIRCUMSTANCES Advise us early in the admission process of any special circumstances which affected your academic performance, especially if you do not meet one or more of the admission requirements. Include a statement of personal circumstances (500-word maximum) with your application describing any personal challenges you ve overcome and explain their impact on your education. Details of any serious illness, diagnosed disability, personal difficulties, or family circumstances that have affected your education are encouraged. ADMISSION REQUIREMENTS You are considered a freshman applicant if you are enrolling directly out of high school, completed the GED, or have accumulated fewer than 36 quarter hours (24 semester hours) of transferable college credit. You are considered a transfer applicant if you have completed 36 quarter hours (24 semester hours) or more of transferable college credits and you have not completed a Bachelor s degree. Freshman applicants Grade point average Earn a high school GPA of at least 3.00 and complete 14 college preparatory subjects. For guaranteed admission, earn a high school GPA of at least 3.25 and complete at least 16 college preparatory units. Essay Submit a one-page essay if you have a high school GPA less than 3.25 on a 4.00 scale or you have completed fewer than 16 college preparatory units. Your essay must address the following topic: The University of Oregon s motto is Mens agitat molem, loosely translated as Minds Move Mountains. What mountain do you want to move and how will you use your University of Oregon education to do so? Do you want to make a difference in a neighborhood, a school, a business, a community, a law, or one person s mind? College Preparatory Subjects Specific details are available online, <admissions.uoregon. edu/apply/freq.htm>. Graduates from Oregon high schools may use the Proficiency-based Admissions Standards System (PASS) to substitute for English, mathematics and sciences courses. English (4 years) Mathematics (3 years) Social Studies (3 years) Science (2 years) Second Language (2 years) SAT or ACT results First year applicants must submit results from either the SAT or ACT.

2 Graduates from non-standard or non-accredited high schools or GED recipients Contact the UO Office of Admissions. GED students must achieve an average score of 580 with a minimum score of 410 on each of the five GED tests. If you completed the GED later than spring 1997, you will also need to complete the second language requirement as stated on the previous page. Transfer Applicants Grade point average If you have completed 24 or fewer transferable credits with a 2.50 GPA, you will be required to meet all other freshman and transfer admission requirements. After you have completed 36 or more transferable credits, you will be required to have a 2.25 GPA and meet all other transfer admission requirements. Course requirements Requirements include a grade of C- or better in college level writing, beginning with WR 121 (English Composition) or it s equivalent and a college level math course. Eligibility You must be eligible to return to the most recent college or university you have attended. Foreign Language Transfer applicants who graduated from high school spring 1997 or later must meet same foreign language requirement as freshman applicants (see previous page). APPLICATION FEE A $50 nonrefundable application fee is required of all applicants for admission. Currently enrolled UO or SOCC students or those who have applied and paid an application fee for the current academic year do not pay an additional application fee. TUITION AND FEES Assessment of tuition and fees is based on the courses for which you register. SOCC tuition and fees are assessed for SOCC courses; UO tuition and fees are assessed for UO courses. The institution that received the tuition and fees handles withdrawals and refunds in accordance with its rules and policies. Tuition is assessed at resident or nonresident rates according to the residency classification of the student. SOCC establishes residency criteria for its courses; the Oregon University System establishes residency criteria for UO courses. Students admitted to the Dual Enrollment and Dual Admission Program who are taking classes at both schools pay fees for each institution according to each institution s standard fee structure. Students have access to free and fee-based services at both campuses. Students enrolled in this program and taking classes at only one institution are assessed fees according to that institution s standard fee structure. Students at one institution who want to access fee-based services at the other institution may request its optional fee package. FINANCIAL AID Financial aid eligibility for students accepted into the Dual Enrollment and Dual Admission Program is determined as follows: 1. SOCC evaluates and awards financial aid to applicants with 0 89 earned credits. 2. The UO evaluates and awards financial aid to applicants with 90 or more earned credits. Students are expected to abide by the financial aid policies and procedures of the institution evaluating and awarding financial aid and may apply for academic and departmental scholarships at either institution. View the complete University of Oregon SOCC Dual Enrollment Agreement online, <admissions.uoregon.edu/dualenroll.html> FOR MORE INFORMATION Contact the University of Oregon Office of Admissions or the SOCC Office of Admissions and Records. University of Oregon Office of Admissions, 240 Oregon Hall 1217 University of Oregon, Eugene OR (541) or (800) BE-A-DUCK Southwestern Oregon Community College Office of Admissions and Records 1988 Newmark Avenue, Coos Bay, OR (541) SOCIAL SECURITY NUMBER DISCLOSURE To comply with the Tax Payer Relief Act of 1997, the University of Oregon must obtain your correct social security number (SSN) to file returns with the Internal Revenue Service (IRS) and to furnish a statement to you. The returns filed by the UO must contain information about qualified tuition and related expenses. The Privacy Act of 1974, section 6109 of the Internal Revenue Code, requires that you give your correct SSN to agencies who must file information returns with the IRS. The IRS uses your SSN for identification and to verify the accuracy of your tax return. For more information, please refer to Internal Revenue Code section 6050S. By signing the application, you give your permission for the use of your SSN to assist the UO and the OUS (and organizations conducting studies for or on behalf of the OUS) in developing, validating, or administering predictive tests and assessments; administering student aid programs; improving instruction; identifying students internally; collecting student debts; or comparing student educational experiences with subsequent work-force experiences. When conducting studies, the UO and the OUS will disclose your SSN only in a manner that does not permit personal identification of you by individuals other than representatives of the UO and the OUS (or the organization conducting the study for the OUS) and only if the information is destroyed when no longer needed for the purposes for which the study was conducted. By providing your social security number, you are consenting to the uses identified above. This request is made pursuant to Oregon Revised Statutes and You are not required to consent to the use of your SSN for research; if you choose not to do so, you will not be denied any right, benefit, or privilege provided by law. You may revoke your consent for the use of your SSN at any time by writing to the Office of Admissions. If you do not give consent to use your SSN for research, please attach a note requesting a system-generated number.

3 APPLICATION FOR ADMISSION TO THE UO AND SOCC DUAL ENROLLMENT PROGRAM Either a nonrefundable $50 (U.S.) fee or a fee-deferral form must accompany this application. Make check payable to University of Oregon and put student s name Paid by: check and social security number on check. VISA MasterCard Credit card number Exp. date Signature of card holder Name (exactly as it appears on card) For office use only For office use only PD NF FD 1. Legal name 2. Other names that may appear on your academic records 3. Secure student identification number (Oregon applicants only) See page 9 for details. 4. Social security number (required) Application for (one only): Fall (September) Winter (January) Spring (March) Summer (June) 6. Intended major Career objective SOCC Intended major 7. Have you previously applied to or attended the UO? Yes No If yes, date of last application: Term Year Last term attended: Term Year 8. Mailing address City County or province 9. Permanent address City County or province Last (family name) Code 10. address Yours Other 11. Sex (optional): Male Female Date of birth - - Place of birth 12. Ethnic identity (optional). In compliance with federal reporting requirements, Oregon University System universities must seek to identify the ethnic background of applicants for admission. You are encouraged to supply this information but may decline without in any way prejudicing your application. Asian Black or African American, non-hispanic Hispanic or Latino or Chicano Number and street or P.O. box State Nation Number and street State Nation Native American or Alaska Native White, non-hispanic Pacific Islander North African Middle Eastern Multiracial Other Decline response 13. Citizenship classification (check one) U.S. citizen Nonimmigrant student using F or J visa Specify tribal affiliation U.S. permanent resident; list alien registration number Other; list your immigrant status while in U.S. If a U.S. permanent resident, attach a copy of visa or front and back of U.S. immigrant-status card 14. Employment status. Are you currently employed? Yes No If yes, Full-time Part-time 15. Veteran status. Are you a veteran of the United States Armed Forces? Yes No Please read the OUS Social Security Number Statement on page Contact information. List parents or legal guardians who know where you can be reached. Other relatives or friends may be listed. ZIP ZIP First Middle Last First Middle Year Year Year Year Month Day Year City Country s Last First Middle Number and street City State ZIP Relationship: Mother Father Legal guardian Friend Other 17. Parent s education level (optional). Highest level of education achieved by either of your parents. Middle school or junior high Some high school High school diploma or GED Some college Associates degree Bachelors degree Other (specify)

4 18. Academic information. Request official transcript, including courses in progress, then send final transcript after graduation. Attach an explanation if your record has been affected by unusual circumstances. Name of high school City State HS CEEB Code Date of graduation - - Month Day Year Your rank in a class of. If precise rank is not available, indicate rank to nearest decile (1st decile is top 10%) Your GPA Cumulative through semester: six seven eight See page 1 if your GPA is below Is GPA based on weighted grades? Yes No If yes, attach a copy of your weighted grading policy. GED students. Date you took or plan to take the GED examination - - Test scores. Report the highest composite on a single test date for each of the tests you took: SAT I: V M Date taken ACT: Date taken SAT II: Subject Score Subject Score Subject Score Date taken 19. I certify that the information in section 16 has been verified and is accurate. High school adviser s signature Print name Date Phone Month Day Year ENG MATH READ SCI COMP COLLEGE ATTENDANCE TRANSFER STUDENTS AND FRESHMEN WITH COLLEGE CREDIT 20. Colleges attended. List every college you have attended, are attending, or from which you will receive credit (including the UO). Failure to list all colleges attended may result in denial of admission or disciplinary action. Have official transcripts from schools other than the UO sent to the Office of Admissions. School Location (city, state) Enrollment (month, year) Credits completed Degree received from to Attach a separate sheet of paper to list more colleges Courses in progress College, location Total credits Courses planned Term College, location Total credits TRANSFER APPLICANTS THE QUESTIONS BELOW ARE REQUIRED FOR ALL TRANSFER APPLICANTS 21. How will you have completed a college-level writing course by the time you enter the University of Oregon? Course number and title Course number and title College College Date taken or planned 22. How will you have completed a college-level writing course mathematics course (with a prerequisite of intermediate algebra or above) by the time you enter the University of Oregon? Date taken or planned Term Term Year Year 23. High school graduation year High school attended If you graduated spring 1997 or later, check all that apply. I completed: two years of the same second language in high school Official transcripts must be sent to the UO for verification. two terms of the same second language in college

5 RESIDENCY CLASSIFICATION FOR TUITION PURPOSES Residency requirements at the UO are different from those at SOCC. Please note that, though you may be classified as a resident at SOCC, your residency status at the UO is not guaranteed. Please complete all questions in this section. FAILURE TO ANSWER ALL QUESTIONS WILL CAUSE YOU TO BE CLASSIFIED AS A NONRESIDENT 24. Residency classification for tuition purposes For tuition purposes, do you consider yourself a resident of Oregon? Yes No If yes, completion of all questions in this section is required. Failure to do so will result in your classification as a nonresident. If you are under the age of 24, you must complete the parent or guardian section. Additional information may be required. Did a parent or legal guardian claim you as a dependent in the prior tax year? Yes No Did a parent or legal guardian provide at least half of your support in the past twelve months? Yes No Is your high school diploma or GED from Oregon? Yes No Additional documentation may be required to substantiate residency. COMPLETE THE FOLLOWING (REQUIRED) IF YOU ARE UNDER 24 MOTHER FATHER GUARDIAN Date of most recent continuous presence in Oregon (mo/yr) from / to / from / to / Issue date of current Oregon Driver s License (mo/yr) / / Date of Oregon Voter Registration (mo/yr) / / Dates of military service (mo/yr) from / to / from / to / Did you enter the military service from Oregon? Yes No Yes No List last two years Oregon income taxes have been filed Date of employment in Oregon (mo/yr) Parent s Employer from / to / City State Student s Employer from / to / 25. Freshman and Transfer Applicants. You are encouraged to explain any extenuating circumstances that affected your academic record. See page 1 for details. PERSONAL STATEMENT 26. Freshman Applicants. If you are required to submit an essay, include it with this application. See page 1 for details. CERTIFICATION APPLICATION MUST BE SIGNED FOR PROCESSING 27. I certify that I have provided complete and accurate statements on this application. To the best of my knowledge, all official documents are authentic, unaltered records that pertain to me. I understand that all official documents submitted in support of this application become the property of the University of Oregon and cannot be returned, copied, or transferred to a third party. I understand that failure to list all colleges attended or falsification of official documents may result in denial of admission or disciplinary action. I have been informed that my application fee of $50 is nonrefundable. I authorize the release of any information submitted by me in connection with this application to any person, firm, corporation, association, or government agency, but only to verify or explain the information. I authorize the UO and SOCC to share and release information related to my dual admission and enrollment between the two institutions. I authorize to make inquiries regarding my applications, transcripts, test scores, and other supporting documents on my behalf during the admission process (optional). Signature Your signature certifies the accuracy and completeness of the information provided. Date RETURN TO: ADMISSIONS OFFICE UNIVERSITY OF OREGON 1217 UNIVERSTIY OF OREGON EUGENE, OR 97405