No application will be considered without an application fee of $50 (nonrefundable) Last Name First Name Middle Name Social Security Number



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APPLICATION FOR UNDERGRADUATE ADMISSION IGNATIUS UNIVERSITY (Indianapolis, Indiana) Mail to: Undergraduate Admissions office 2295 Victory Blvd. Staten Island, NY 10314 (718) 698-0700 No application will be considered without an application fee of $50 (nonrefundable) enclosed. Please type all information: Personal Information: - Last Name First Name Middle Name Social Security Number Former Last Names, if any. Address City County State Zip Home Telephone (area code) Fax E- mail Full-time Employer (if any) Business Telephone (area code) Fax Sex Male Female Date of Birth / / Marital Status: Single Married Other If married, Spouse's Full Name Highest Education Citizen of USA Yes No If no, International Resident

Religious Preference (optional) Parish or Congregation and City Ethnic Origin (optional) White Asian-Pacific Islander Hispanic African-American Native-American Other Required Photos: Attach the following: photocopy of Driver's License and Passport; current original professional passport size photo; several snap shots of yourself. All photos must have your signature on the bottom of photo. Optional Photos: Snap shots of you with family and/or relatives and friends. All these photos are especially important today in view of Distance Learning. Family Information: Father or Legal Guardian's Full Name: Address (if other than yours): Telephone (if other than yours): Did father attend college? Yes No If yes, state where: Mother's Full name (include Maiden name): _ Address (if other than yours): Telephone (if other than yours): Did mother attend college? Yes No If yes, state where: Names and ages of brothers, sisters, or children: List name and relationship of any relatives who are attending or have attended

Ignatius University: How did you learn about Ignatius University? Academic Information: Intended Major: Minor Degree Objective: Bachelor (4 years) Associate (2 years) Requested Date of Student Enrollment: Term Year October February June Continuous Date you wish to begin: Student Status: FR-First-time Freshman Adult Freshman (24 years or older) TR-Transfer SD-Second Bachelor's Degree SP-Second Ignatius Degree CE-Certification Only HI-Special High School Student Classification: Full Time Part Time Learning Location: I wish to study in Indianapolis Staten Island by Distance Learning Europe Combination Housing Plan: Campus Housing Commute To which colleges are you applying High School Information:

Name of High School Address City County State Zip School Telephone High School Counselor High School CEEB Code Dates of Attendance from to Date of Graduation or date of GED Date you took (or plan to take) Scholastic Aptitude Test (SAT) Month Year SAT scores must be sent to IGNATIUS UNIVERSITY ADMISSION'S OFFICE. Have you requested that high school transcript be sent to Ignatius University? Yes No (If no, please send as soon as possible). Previous College Attendance: Name of Institution Location From / to / Credits Degree Name of Institution Location From / to / Credits Degree Name of Institution Location From / to / Credits Degree Please request that official transcripts be sent from each school to Ignatius University, Office of Admissions. HIGH SCHOOL EXTRACURRICULAR ACTIVITIES AND COLLEGE EXTRACURRICULAR (Optional)

Letters of Recommendation Two letters of recommendation are necessary: one letter from any teacher at your high school or college recommending you for college studies; this letter must be on school stationery; the second letter is needed from a clergy person indicating your good moral character; and this document should be submitted on clergy stationery. IMPORTANT: Misrepresentation in any statement may be considered sufficient reason for refusal of admission or cancellation of admission after acceptance. High School and/or College transcripts and SAT must be sent to the above address before your application will be considered for admission. Please Note: Transcripts, once submitted, become the property of the Ignatius University and are not returnable. IGNATIUS UNIVERSITY DOES NOT DISCRIMINATE ON THE BASIS OF GENDER, RACE, AGE, HANDICAP. NATIONAL ORIGIN OR CREED IN ADMINISTRATION OF ANY OF ITS POLICIES. I hereby certify that the information given in this application is accurate and complete, to the best of my knowledge. If I am accepted as a student, I agree to abide by the policies, philosophy of conduct, and expectations of IGNATIUS UNIVERSITY. I have read in its entirety the information on Ignatius University including the material on history, mission, accreditation, degree requirements, grades and fees. Date Signature Please return completed application to: Office of Admissions Ignatius University 2295 Victory Boulevard Staten Island, N.Y 10314