WINSTON-SALEM STATE UNIVERSITY

FRESHMEN TRANSFER STUDENTS NON-WSSU SECOND DEGREE STUDENTS NON-DEGREE & SUMMER SCHOOL TEACHER CERTIFICATION/LICENSURE READMISSION UNDERGRADUATE INTERNATIONAL WINSTON-SALEM STATE UNIVERSITY MAIL COMPLETED APPLICATION TO: WSSU, 601 S. Martin Luther King, Jr. Drive, Offie of Admissions - Thompson Student Center, Suite 206, Winston-Salem, NC 27110

MAJORS 1. Aounting 2. Art 3. Biology 4. Biotehnology 5. Birth to Kindergarten Eduation 5a. Birth to Kindergarten Eduation DL* 6. Business Administration 7. Chemistry 8. Clinial Laboratory Siene 8a. Clinial Laboratory Siene DL* 9. Computer Siene 10. Eonomis 11. Elementary Eduation (K-6) 12. English 13. English, Seondary Eduation 14. Exerise Siene 15. Finane 16. Gerontology 17. Health Care Management 18. History 19. Information Tehnology 20. Interdisiplinary Studies 20a. Interdisiplinary Studies DL* 21. Justie Studies 22. Management 23. Management Information Systems 24. Marketing 25. Mass Communiations 26. Mathematis 27. Mathematis, Seondary Eduation 28. Middle Grades (6-9) 29. Motorsports Management 30. Musi 31. Nursing 31a. RN-BSN DL* option 31b. RN-BSN (on WSSU ampus) 31. Aelerated Nursing (Seond Degree Only) 32. Physial Eduation 33. Politial Siene 34. Psyhology 35. Rehabilitation Studies 36. Soial Work 37. Soiology 38. Spanish 39. Speial Eduation, Speifi Learning Disabilities (K-12) 40. Sport Management 41. Therapeuti Rereation NOTE: *Distane Learning Options FOR MORE INFORMATION, EMAIL: Admissions@wssu.edu APPLICATION CHECKLIST Freshman Appliation for Undergraduate Admission $50 Non-Refundable Appliation fee Offiial High Shool Transript (appliants under the age of 24) Offiial ACT or SAT test sores with a writing sore (appliants under the age of 24) Offiial College Transript (if appliable for dual enrollment oursework) Make opies of all douments submitted for review Transfer/(Seond Degree)/Evening-Weekend/Teaher Certifiation/Distane Learning Appliation for Undergraduate Admission $50 Non-Refundable Appliation fee Offiial High Shool Transripts (appliants under the age of 24 who have not obtained an Assoiates Degree) Offiial ACT or SAT test sores with a writing sore (appliants under the age of 24 who have not obtained an Assoiates Degree) Offiial College Transripts (remember to submit a transript from eah institution you have previously attended) Make opies of all douments submitted for review International Appliation for Undergraduate Admission $50 Non-Refundable Appliation fee Offiial High Shool Transripts (appliants under the age of 24) Course-by-ourse redential evaluation by World Eduation Servies or another international aademi redential evaluation servie for transfers with ollege oursework from institutions outside of the U.S.A. Offiial ACT or SAT test sores with a writing sore (appliants under the age of 24) Offiial College Transripts (remember to submit a transript from eah institution you have previously attended) Offiial Test of English as a Foreign Language (TOEFL) sores Certifiate of finanial responsibility and doumentation showing suffiient finanial resoures for the duration of the student s stay in the United States of Ameria Proof of graduation from a seondary shool Make opies of all douments submitted for review Summer Shool Only Visiting Appliation for Undergraduate Admission $50 Non-Refundable Appliation fee Offiial transript from the most urrent institution Make opies of all douments submitted for review Non-Degree Seeking Appliation for Undergraduate Admission $50 Non-Refundable Appliation fee Offiial transript from the most urrent institution Make opies of all douments submitted for review Winston-Salem State University is ommitted to equality of eduational opportunity and does not disriminate against appliants, students or employees based on rae, olor, national origin, religion, gender, age or disability. It is the poliy of Winston-Salem State University to reate diversity among its student body by reruiting and enrolling students without regard to rae, gender or ethniity. Appliants of all raes, gender, and ethni bakgrounds are enouraged to apply for enrollment. MAIL COMPLETED APPLICATION TO: WSSU, 601 S. Martin Luther King, Jr. Drive, Offie of Admissions - Thompson Student Center, Suite 206, Winston-Salem, NC 27110

FRESHMAN REQUIREMENTS Winston-Salem State University defines a freshman as any student that has ompleted the neessary requirements for graduation from the K-12 system or ompletion of a high shool equivalene program, and has not enrolled in a two or four year ollege/university. We invite these students to apply to the university under our Freshman Requirements. There are several fators that will be used to evaluate appliants for admission to Winston-Salem State University. Fators used to evaluate a student s appliation are: Quality of High Shool Aademis, Aademi Ahievement, Standardized Test Sores. Aording to the University of North Carolina system, students applying for admission must provide evidene that they have ompleted or will omplete the Minimum Course Requirements as listed below: Four (4) units/years of ollege preparatory English Four (4) units/years of Math Algebra I Geometry Algebra II A math ourse higher than Algebra II (For example: Pre-Calulus, Calulus, Statistis, Models & Funtions, Differential Equations and Trigonometry) Three (3) units/years of Siene 1 unit/year of Biologial Siene 1 unit/year of Physial Siene 1 units/year of an additional Siene Two (2) units/years of Soial Siene 1 unit/year of Amerian or U.S. History 1 unit/year of a ourse of your hoosing in the Soial Siene field Two (2) units/years of the same Foreign Language TRANSFER REQUIREMENTS Winston-Salem State University defines a Transfer as any student that has ompleted the requirements of the K-12 system and has ontinued their eduation at a two or four year ollege/university prior to the submission of an appliation to WSSU. All transfers over the age of 24 are required to submit all offiial transripts from eah ollege/university attended. All transfers under the age of 24 who have not obtained an Assoiates degree are required to submit an offiial high shool transript, SAT/ACT sores, and offiial transripts from eah ollege/university attended. Transfer students should remember that: Letter grades of C or higher must be obtained in ollege level oursework to be onsidered for transfer redit Students must be in good aademi and disiplinary standing at all previous institution(s) and eligible to return to the last institution attended Must have a umulative G.P.A. of 2.0 or higher on last institution attended To be onsidered for transfer redit, oursework must be ompleted at a regionally aredited institution. SECOND BACCALAUREATE DEGREE SEEKING STUDENTS Winston-Salem State University defines a Seond Degree as any student that has previously ompleted the requirements and earned a Baalaureate Degree. An earned degree must be refleted on offiial transript Must have a umulative G.P.A. of 2.0 or higher Must submit offiial transripts from eah ollege/university attended READMISSION: (FORMER WSSU STUDENTS ONLY) Students who have been dismissed or disontinued their undergraduate studies may be eligible for readmission to the university. Previous aademi history will be reviewed upon reeipt of appliation to determine eligibility. Students who have not attended another ollege/university sine leaving WSSU are not required to pay an appliation fee. Students who have attended another ollege/university sine leaving WSSU must submit a $50 appliation fee, along with offiial transripts from the other institution(s). If attended another ollege appliant must have obtained at least 2.0 GPA from the last attended institution.

NON-DEGREE SEEKING STUDENTS/TEACHER CERTIFICATION AND COMPUTER SCIENCE CERTIFICATION STUDENTS Eah semester, individuals have an opportunity to be admitted as Non-degree seeking students, and aquire up to 12 redit hours. *Please note the following: Winston-Salem State University assumes no responsibility for determining a student s ourse seletion when the redits are to be transferred to another institution. Students are also not eligible for finanial aid under this status. Credits obtained in this manner will not ount towards a degree until a student has met the admission requirements through the Freshman or Transfer proess. SUMMER SCHOOL APPLICANTS Admission to Summer Shool (Session I & II) is open to visiting students who wish to enroll at WSSU and who intend to transfer ourses bak to their home institution. Students who are interested in taking lasses to transfer to other olleges/universities should obtain approval from their home institution of transfer redit prior to submission of an appliation. High Shool seniors and juniors are eligible for summer enrollment. Possible andidates must display exeptional aademi ahievement that meet or exeed the standards of freshman admission. Students must provide a formal endorsement from their Prinipal on shool letterhead. First time freshmen are not eligible for summer shool. UPDATE ADMISSION: We do not allow students to update appliations. Students must submit a new appliation and pay the $50 appliation fee.

Entry Term: m Fall (Aug-De) m Spring (Jan-May) Year m Summer I (May-Jul) m Summer II (Jun - Jul) Student Type: Freshman Visiting Teaher Certifiation/Liensure Non-Degree Computer Si. Cert. Readmission Transfer Seond Degree Update Student Attribute: Distane Learner INTENDED MAJOR Please refer to the opposite page for a list of majors. The major you hoose doesn t affet our admission deision; we use it to assign your advisor. Write undeided if you are unsure. PLEASE NOTE: To selet DL, you must enroll in a distane learning program. Soial Seurity number: You are strongly enouraged to provide your Soial Seurity number (SSN) so that the University may more easily verify your information and proess any finanial aid and/or sholarship appliation you may submit. Submission of your SSN on this form is voluntary, however. If you submit your SSN on this form, the University will use it to reate a unique University identifier to verify reords and math douments assoiated with your appliation, enrollment, and other eduational reords. Please note that, if you enroll at the University, you will be required to provide your SSN in order for the University to omply with federal and state reporting requirements. Soial Seurity #: - - FULL LEGAL NAME (PLEASE PRINT): Former last name (if appliable): Birth Date: / / Gender: Female Male Plae of birth: PARENT E-MAIL ADDRESS We will use this frequently to send you important information. @ STUDENT E-MAIL ADDRESS We will use this frequently to send you important information. @ MAILING ADDRESS Where we should reah you between now and the beginning of the semester. Please notify us in writing if this address hanges. Address: Country (if not U.S.): Permanent Phone: ( ) Cell Phone: ( ) Other Phone: ( ) PERMANENT ADDRESS please give your urrent mailing address for all admission orrespondene. Please notify us in writing if this address hanges. Current mailing address MONTH DAY YEAR LAST FIRST MIDDLE SUFFIX (JR., SR., ETC.) LAST OR FAMILY FIRST MIDDLE SUFFIX (JR., SR., ETC.) CITY/STATE OR PROVINCE/COUNTRY STREET ADDRESS OR PO BOX CITY STATE ZIP NUMBER & STREET APARTMENT # CITY/TOWN STATE/PROVINCE COUNTRY ZIP POSTAL CODE Legal Resideny Are you a resident of North Carolina? Yes Indiate the North Carolina ounty in whih you reside: How long have you lived in North Carolina? From to No, not a resident of North Carolina MONTH/DAY/YEAR MONTH/DAY/YEAR RESIDENCY INFORMATION FOR TUITION PURPOSES Not a North Carolina resident. Consider me out-of-state for tuition purposes. North Carolina resident. County of residene: ETHNICITY How would you desribe yourself? Please hek all that apply. Are you Hispani or Latino? Yes No RACE Selet one or more of the following raial ategories. Amerian Indian or Alaska Native Blak or Afrian Amerian White I hoose not to dislose this information Asian Native Hawaiian or Other Paifi Islander CITIZENSHIP U.S. Citizen Permanent Resident Alien (hold Green Card Form I-151) RECEIPT # STATE OF RESIDENCE Non-Resident Alien # DATE OF ISSUE CITIZENSHIP COUNTRY If you are a itizen of another ounty, you will need to file a finanial ertifiation form as required by law. For a opy, go to www.wssu.edu. Refer bak to heklist. Current visa status (hek if appliable) A B-1/2* F-1 F-2 J-1 J-2 G H PR Other Type of visa requesting (hek if appliable) A F-1 F-2 J-1 J-2 G H PR Other STATE/PROVINCE CITIZENSHIP COUNTRY EMERGENCY CONTACT: LAST NAME Home phone: ( ) Work: ( ) FIRST RELATIONSHIP: MAIL COMPLETED APPLICATION TO: WSSU, 601 S. Martin Luther King, Jr. Drive, Offie of Admissions - Thompson Student Center, Suite 206, Winston-Salem, NC 27110

ACADEMIC INFORMATION Please hek programs/ourses taken in high shool: Advaned Plaement Honors International Baalaureate Did you reeive a general eduation development ertifiate (GED)? Yes, No N/A Did you reeive an adult high shool diploma? Yes, No N/A MONTH / YEAR MONTH / YEAR List all high shools you have ever attended for any length of time. (list most reent first and attah an additional sheet if neessary) HIGH SCHOOL ADDRESS DATES ATTENDED HIGH SCHOOL ADDRESS DATES ATTENDED Date of High Shool Graduation: MONTH / YEAR List all olleges/universities you have ever attended for any length of time. (list most reent first and attah an additional sheet if neessary) COLLEGE / UNIVERSITY ADDRESS DATES ATTENDED (MONTH / YEAR) DEGREE EARNED COLLEGE / UNIVERSITY ADDRESS DATES ATTENDED (MONTH / YEAR) DEGREE EARNED Is Winston-Salem State University your first hoie? Yes No If no, please indiate your first, seond and third hoies: 1. 2. 3. APPLICANT CERTIFICATION In an effort to maintain a safe learning ommunity, we must ask the following questions of all appliants. For the purpose of the following questions, rime or riminal harge refers to any rime other than a traffi related misdemeanor or an infration. You must, however, inlude any alohol or drug related offenses whether or not they are traffi related inidents. Answering yes to any of the following questions may not neessarily prelude your being admitted. However, failing to answer these questions, or failing to respond ompletely, aurately, and truthfully, may be grounds to deny or withdraw your admission or to dismiss you after enrollment. If you answer yes to any of these questions, please provide a written explanation that gives the approximate date of eah inident, explains the irumstanes, and reflets on what you learned from the experiene. The university reserves the right to require an additional statement from an appropriate offiial orroborating your aount, either before ating on your appliation or before permitting you to enroll. Your failure to provide suh a statement upon request may be grounds to deny or withdraw your admission or to dismiss you after enrollment. You are required to notify the university immediately and in writing of any new or pending riminal harge, any disposition of a riminal harge, or any shool, ollege, or university disiplinary ation against you, or any type of military disharge other than an honorable disharge, or any non-routine absene from shool, that ours at any time after you submit this appliation and prior to enrollment. Your failure to do so may be grounds to deny or withdraw your admission or to dismiss you after enrollment. 1. Yes No Have you ever been found responsible for a disiplinary violation at any eduational institution you have attended from 9th grade (or the international equivalent) forward, whether related to aademi misondut or behavioral misondut, that resulted in your probation, suspension, removal, dismissal, or expulsion from the institution? 2. Yes No Have you ever been adjudiated guilty or onvited of a misdemeanor, felony, or other rime? [Note that you are not required to answer yes to this question, or provide an explanation, if the riminal adjudiation or onvition has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise ordered by a ourt to be kept onfidential.] 3. Yes No Do you have any riminal harges pending against you? 4. Yes No Have you entered a plea of no ontest or nolo ontendere, or an Alford plea, to a misdemeanor, felony, or other riminal harge; or reeived a deferred proseution or prayer for judgment ontinued for suh a harge; or otherwise aepted responsibility for suh a rime? 5. Yes Have you reeived any type of disharge from military servie other than an honorable disharge? No - Never Served No - Currently Serving No - Honorably Disharged 6. Yes No If your eduation was or will be interrupted, indiate here and provide details in additional information setion. I hereby aknowledge that WSSU may verify the information set forth herein from soures permitted under law and that the institution may divulge the ontents of this appliation only as permitted under the Family Eduational Rights and Privay At of 1974, if I am or have been in attendane at this institution. I understand my failure to provide omplete, aurate, and truthful information on this appliation will be grounds to deny or withdraw my admission, or dismiss me after enrollment. Signature of Appliant If appliant is under 18 years of age, signature of parent or guardian Date Date

MILITARY STATUS FOR FINANCIAL AID AND RESIDENCY DETERMINATION a. Are you urrently serving or have you ever served in the United States Armed Fores? No Yes b. Are you a dependant or spouse of a urrent or prior United States servie member? No Yes If you answered yes to question (a) above, please answer the following: 1. Your Current Status: Ative Duty NC National Guard Other National Guard Reservist Separated Veteran Retiree 2. Branh of Servie: Army Air Fore Marine Corps Navy Coast Guard 3. Current or Last Pay Grade: E-1 E-2 E-3 E-4 E-5 E-6 E-7 E-8 E-9 O-1 O-2 O-3 O-4 O-5 O-6 O-7 O-8 O-9 O-10 O-11 W-1 W-2 W-3 W-4 W-5 4. Do you plan to use military or veterans eduational benefits while enrolled at this institution? No Yes Not Sure If yes, whih benefit do you plan to use? Chapter 30 Montgomery GI Bill Chapter 31 Voational Rehabilitation Chapter 33 Post 9/11 GI Bill Chapter 35 Dependents Eduation Assistane (DEA) Chapter 1606 Seleted Reserves GI Bill Chapter 1607 Reserves Eduation Assistane Program (REAP) Military Tuition Assistane Military Spouse Career Advanement Aounts (MyCAA) Marine Gunnery Sgt. John David Fry Sholarship Not Sure 5. Your urrent or last permanent duty station: Fort Bragg Camp Lejeune MCAS Cherry Point MCAS New River Pope Army Airfield Seymour Johnson AFB USCG North Carolina Other installation outside of NC NC National Guard Other National Guard Reservist 6. Your urrent or last home of reord: 7. Your state of legal residene last laimed on your DD Form 2058 (State of Legal Residene Certifiate) 8. Date of initial entry into military servie: 9. Disharge or retirement date (atual or antiipated): 10. If disharged, your final duty station: Fort Bragg Camp Lejeune MCAS Cherry Point MCAS New River Pope Army Airfield Seymour Johnson AFB USCG North Carolina Other installation outside of NC NA - NC National Guard NA - Other National Guard NA Reservist If you answered yes to question (b): Please omplete the following if you are the dependent or spouse of someone urrently serving or who has ever served in any branh or status in the United States Armed Fores. This information will help us onnet you with finanial aid benefits and determine your eligibility for in-state resideny. 1. Your relationship to the servie member or veteran: Dependent Spouse 2. Current Status of Servie Member: Ative Duty NC National Guard Other National Guard Reservist Separated Veteran Retiree 3. Branh of Servie: Army Air Fore Marine Corps Navy Coast Guard 4. Current or Last Pay Grade of Servie Member: E-1 E-2 E-3 E-4 E-5 E-6 E-7 E-8 E-9 O-1 O-2 O-3 O-4 O-5 O-6 O-7 O-8 O-9 O-10 O-11 W-1 W-2 W-3 W-4 W-5 5. Do you plan to use military or veterans eduational benefits while enrolled at this institution? No Yes Not Sure

MILITARY STATUS FOR FINANCIAL AID AND RESIDENCY DETERMINATION If yes, whih benefit do you plan to use? Chapter 30 Montgomery GI Bill Chapter 31 Voational Rehabilitation Chapter 33 Post 9/11 GI Bill Chapter 35 Dependents Eduation Assistane (DEA) Chapter 1606 Seleted Reserves GI Bill Chapter 1607 Reserves Eduation Assistane Program (REAP) Military Tuition Assistane Military Spouse Career Advanement Aounts (MyCAA) Marine Gunnery Sgt. John David Fry Sholarship Not Sure 6. Current or last permanent duty station of servie member: Fort Bragg Camp Lejeune MCAS Cherry Point MCAS New River Pope Army Airfield Seymour Johnson AFB USCG North Carolina Other installation outside of NC NC National Guard Other National Guard Reservist 7. Current or last home of reord of servie member: 8. What is/was the state of legal residene last laimed on his/her DD Form 2058 (State of Legal Residene Certifiate)? 9. Date of initial entry into military servie for the servie member: 10. Disharge or retirement date of servie member (atual or antiipated): 11. If disharged or retired, servie member s final duty station: Fort Bragg Camp Lejeune MCAS Cherry Point MCAS New River Pope Army Airfield Seymour Johnson AFB USCG North Carolina Other installation outside of NC NA - NC National Guard NA - Other National Guard NA Reservist September 2014