Application for Undergraduate Admission

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1 Application for Undergraduate Admission Applicants must complete the Admission Application fully and return it to the Office of Admission, along with the non-refundable $40 application fee (check or money order payable to Lewis University). To be completed by applicant. Please Print in Ink. (ALL FIELDS ARE REQUIRED UNLESS DESIGNATED AS OPTIONAL.) Last Name First Name M.I. Maiden Name (If Applicable) Social Security Number* Date of Birth Present Age *A valid Social Security number (SSN) is required if you are applying for financial aid. Applicants who do not provide an SSN or who enter an incorrect number may experience a delay in receiving a financial aid award letter. Applicants who are not U.S. citizens and do not have an SSN should use zeros. Address (Required) Permanent Address City State Zip Code County Do we have your permission to send you a text message? Yes No Anticipated Major: (See back panel for a complete list of majors). If unsure, write undecided. Anyone interested in Secondary Education must list their major designation from the list provided. I will enroll as a: Full-Time Student Part-Time Student I will be: Degree Seeking Non-degree seeking 2nd BA/BS Degree I will enter Lewis: Fall Spring Year: 20 Gender: Male Female Marital Status: Single Married Do you plan to live on campus? Yes No Have you previously enrolled in classes at Lewis University? Yes No U.S. Citizenship/Immigration Status: I am a U.S. citizen. I am a permanent resident. Alien Registration Number : I am not a U.S. citizen or permanent resident. What is your country of citizenship? What is your visa type? B1 B2 F1 H1 H2 J1

2 Military Experience: Are you a veteran of the U.S. Armed Forces? Yes No Are you currently serving the U.S. Armed Forces on Active Duty? Yes No Are you currently serving the U.S. Armed Forces in the Reserves? Yes No Race/Ethnicity: These questions comply with the U.S. Department of Education s new standards for collection of ethnic and racial data. Your response is optional. 1. Are you Hispanic or Latino? Yes No 2. If you answered No above, please indicate your primary race/ethnicity by placing a 1 on the corresponding box below and, if you wish to identify secondary races/ethnicities, please choose one or more and place a 2 on as many boxes as appropriate. If you answered Yes above, and you wish to identify secondary races/ethnicities, please choose one or more and place a 2 on as many boxes as appropriate. American Indian or Alaskan Native Asian Black or African American White or Caucasian Native Hawaiian or Other Pacific Islander Religious Preference: High School or Home School From Which You Will Graduate or Have Graduated High School Name City State Date of Graduation (Month and Year) Guidance Counselor Name Counselor Who or What Influenced You to Apply to Lewis? Please check the extracurricular activities in which you would like to participate in college. (Check all that apply) Interests: Academic clubs Community Service Mock Trial/Debate Scholars Academy Art Cultural events Music Sororities/Fraternities Aviation Flight team Intramural sports Radio/TV Student Government Campus ministry Marching Band ROTC Theatre Athletics: Badminton Diving Rugby Volleyball Baseball Football Soccer Water Polo Basketball Golf Softball Wrestling Bowling Gymnastics Swimming Other Cheerleading Hockey Tennis Cross Country Lacrosse Track & Field College/University Credit. Please complete the following and send an official transcript from each institution at which you have received college credit. Name of College/University Dates Attended

3 Family Information Parents Marital Status: Single Married Separated Divorced Widowed With which Parent/Guardian do you reside? If someone other than parent serves as a legal guardian, list name. Parent/Guardian 1 Mr. Ms. Mrs. Miss Dr. Parent/Guardian 2 Mr. Ms. Mrs. Miss Dr. Last Name First Name Address Last Name First Name Address Maiden Name ( ) ( ) ( ) ( ) Address Employer Name Title - Position Do we have your permission to send you a text message? Yes No Highest Degree Earned? None H.S. Diploma Associate s Bachelor s Master s Doctorate Lewis Alumni? Yes No If Yes, Class Year when graduated Address Employer Name Title - Position Do we have your permission to send you a text message? Yes No Highest Degree Earned? None H.S. Diploma Associate s Bachelor s Master s Doctorate Lewis Alumni? Yes No If Yes, Class Year when graduated Is your father, mother or spouse a Lewis employee? Yes No Are other members of your household enrolled at Lewis? Yes No If yes, list name, relationship and years: Name Relationship Years Attended Self-Disclosure Have you ever been arrested, indicted or convicted of anything other than a minor traffic violation? Yes No If you answered Yes, please attach an explanation of the circumstances and the approximate date of the incident. Such disclosure does not automatically disqualify an applicant for admission, but these cases will be reviewed by the University Admission Committee. Are you in financial default at any institution of higher learning? Yes No Lewis University does not discriminate against any applicant because of race, color, religion, sex, national origin, age or disability. I certify that the information on this application is correct and complete to the best of my knowledge. I understand that failure to answer any question on this form truthfully, fully, and accurately may make me ineligible for admission to Lewis University or may result in my dismissal from the University. I authorize Lewis University to obtain my test scores, including, but not limited to, any ACT or SAT scores, directly from the appropriate testing agency. I understand that the $40 application fee is non-refundable regardless of the final admission decision. Signature of Applicant Date

4 Admission Profile Middle 50% ACT Composite: Middle 50% SAT Critical Reading: Middle 50% SAT Math: Average High School GPA: 3.40 Factors considered for admission: College-prep coursework High school grade point average Class rank ACT or SAT Academic letters of recommendation (optional) Essay or personal statement (optional) Freshman Students Students are welcome to submit additional personal information regarding their high school activities. Applicants must have graduated from an approved high school or home school with a combination of grade point average, class rank, and ACT or SAT score which indicates a strong likelihood of success in university studies. Official high school transcripts and ACT or SAT scores should be forwarded to the Office of Undergraduate Admission. GED students must submit a copy of their diploma and test scores. Veterans must submit a DD214. If your high school transcripts do not indicate an ACT or SAT score, please order a report from one of the following services: Application Deadlines (Recommended) Status Fall Spring Early Response* December 1 Not applicable Freshman Priority February 1 Not applicable Scholarship Consideration Freshman Regular April 15 January 2 Admission** * Receive admission and scholarship decision before the New Year. ** Rolling admission as space remains available Financial Aid Students who have been accepted for admission to Lewis University are eligible to be considered for financial aid. Lewis requires that students complete the Free Application for Federal Student Aid (FAFSA) in order to apply for need-based financial aid/grants, loans and work programs available through federal, state and institutional resources. Complete the FAFSA online at fafsa.gov Remember to list Lewis University in the school section of the FAFSA. Lewis University code: Please send all application materials to: Lewis University Office of Undergraduate Admission Unit 297 One University Parkway Romeoville, IL College Testing Program ACT Report Services P.O. Box 168 Iowa City, IA act.org Lewis University Code: 1058 College Board SAT Program P.O. Box 6201 Princeton, NJ collegeboard.com Lewis University Code: 1404 Office of Undergraduate Admission lewisu.edu One University Parkway Romeoville, Illinois (815) toll-free (800) fax (815) (16038ONL) 08/2015

5 Academic Majors and Areas of Study At Lewis, we continually develop and modify our academic degree programs to match the requirements of the market s high-demand fields, offering professional preparation grounded in a liberal arts curriculum. Application Checklist FRESHMEN Application Form $40 Application Fee (non-refundable) Official High School Transcript(s) SAT or ACT Test Results Accounting Aerospace Studies (Air Force ROTC)** Athletic Coaching* Athletic Training Aviation Majors Air Traffic Control Management Aviation Administration Aviation and Aerospace Technology Aviation Flight Management Aviation Maintenance Management Aviation Security Avionics Transportation Administration Unmanned Aircraft Systems Biochemistry Biology Business Administration Chemistry Chemical Physics Communication Majors Interactive Media Journalism Organizational Communication Public Relations/Advertising Radio/TV Broadcasting Computer Engineering Computer Graphic Design Computer Science Contemporary Global Studies Criminal/Social Justice Cyber Security* Dental Hygiene~ Diagnostic Medical Sonography~ Drawing Economics Education Majors Combined Special Education/ Elementary Education Early Childhood Special Education Elementary Education Foreign Language Education Middle Level Education Secondary Education Special Education Elected Studies English Environmental Science Ethnic and Cultural Studies African American Studies* Ethnic and Cultural Studies* Latino Studies* Exercise and Movement Science Film Studies* Finance Fitness Management* Foreign Language* Forensic Criminal Investigation Gaming and Simulation** General Studio Art History Human Resource Management Illustration Information Security and Risk Management Information Systems International Business International Relations Law Liberal Arts Marketing Mathematics Medical Laboratory Science~ Military Science (Army ROTC)** Music Music Merchandising Natural Sciences* Nuclear Medicine Technology~ Nursing (BSN) Painting Paralegal Studies Perfusion Technology~ Philosophy Philosophy of Law Physics Podiatric Medicine~ Political Science Project Management* Psychology Public Policy Public History Radiation Therapy~ Radiography~ Respiratory Care~ Social Media Marketing Social Work Sociology Spanish Language and Culture Sport Management Theatre Theology Vascular Ultrasound Technology~ Web and Mobile Application Development* Women s Studies* Pre-Professional Programs Pre-Chiropractic Pre-Dentistry Pre-Engineering Aerospace Engineering Mechanical Engineering Pre-Law Pre-Medicine Pre-Optometry Pre-Pharmacy Pre-Physical Therapy Pre-Physician Assistant Pre-Podiatry Pre-Veterinary Medicine * Available only as a minor ** Offered as a program of study or concentration Combined Bachelors/Masters degree option available Dual-degree program with partner institution ~ Offered with partner health institutions (16038ONL) 08/2015

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