Jamestown College - Online Application

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Application for Admission

Printable Version

Please include with application:

Copy of your high school transcripts (and college transcripts, if applicable).
Copy of your ACT or SAT test scores.

I am applying for admission as a:

First-Year Student Transfer Student

I am applying for term beginning (complete year):

Fall Spring Summer

Student's Information

Male Female

Last Name

First Name

Middle Name

Maiden Name

Prefer Name (Nickname)

Mailing Address

City

State

Postal Code

(Area Code) Tel. Number

(Area Code) Cell. Number

Month

Day

Year

SSN

Country of Birth

Country of Citizenship

Preferred method of correspondence (i.e., e-mail, cell phone, texting, i.m.)

No Yes

Have you ever been convicted of anything other than traffic violations?

Optional

Race/ethnicity

Marital status

Denomination/religious preference

Student's Academic Information (List most recent first)

High school's name

City

State

Phone number

Dates attended (mm/yyyy)

from

Date of Graduation

High school's name

City

State

Phone number

Dates attended (mm/yyyy)

from

Reason for leaving

During high school have you ever been enrolled in coursework for college credit (i.e., AP, dual credit)?

High School Cumulative GPA

Composite ACT/Critical Reading Plus Math SAT score

GED Information (if applicable)

State

Year

Standard score total

Battery average

College Information (if applicable)

College Name

City

State

Area of study

Dates attended (mm/yyyy)

from

Cumulative GPA

College Name

City

State

Area of study

Dates attended (mm/yyyy)

from

Cumulative GPA

College Name

City

State

Area of study

Dates attended (mm/yyyy)

from

Cumulative GPA

Are you in good standing with all prior colleges?

Student Plans at Jamestown College

What course of study/major(s) do you plan
to follow at Jamestown College?

(Use Ctrl-click to make multiple selections)

What extra-curricular activities do you plan to continue or develop at Jamestown College?

Sports

(Use Ctrl-click to make multiple selections)

Organizations

(Use Ctrl-click to make multiple selections)

Financial Aid Information

Have you filed or do you intend to file the FAFSA (Free Application for Federal Student Aid)?

Will you receive financial support from anyone other than your family?

Activities

Please list significant school, church, and community activities, in which you have been a participant:

Family's Information

	Parents married		Father remarried		Father deceased
	Parents separated/divorced		Mother remarried		Mother deceased

Father's Name

Father's occupation/employer

Father's complete address (if different than applicant's)

Father's daytime phone number

Father's cell phone number

Father's e-mail address

Father's level of education/college attended if applicable

Mother's Name

Mother's occupation/employer

Mother's complete address (if different than applicant's)

Mother's daytime phone number

Mother's cell phone number

Mother's e-mail address

Mother's level of education/college attended if applicable

Please list the names and ages of your sibilings.

Name

Age

Year of HS graduation (mm/yyyy)

Name

Age

Year of HS graduation (mm/yyyy)

Name

Age

Year of HS graduation (mm/yyyy)

Please list the following information about family members who are Jamestown College alumni.

Name

Relationship

Date of attendance (yyyy)

Name

Relationship

Date of attendance (yyyy)

Have you ever visited Jamestown College?

How did you hear about Jamestown College?

What three main factors interest you in Jamestown College?

References

You must have two people complete the Online Reference Form. One should be a teacher or counselor at your school. Please list the following information about the two references you have chosen.

*Make sure you entered their correct e-mails and let them know an email from: admissions@jc.edu will be send to them after you submit this form regarding your application.

Reference 1 information

Name

Occupation

Address

City

State

Postal Code

E-mail address

Reference 2 information

Name

Occupation

Mailing Address

City

State

Postal Code

E-mail address

By submiting this form, I agree that the information I have provided is true to the best of my knowledge.

Statement of Nondiscrimination:

Jamestown College confirms its support of the principles and practices of nondiscrimination and equality of races and sexes in its employment and in all of its programs, activities, and opportunities available to students. Jamestown College also affirms a commitment to nondiscrimination and reasonable accommodation of those students who are disabled. It is the expressed intent of Jamestown College to be in conformity with all laws relating to higher education which are consistent with our commitment to the Christian ethic, including Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990. Students who believe they may have a qualifying disability should request a complete copy of policies and procedures available from the Office of Admissions, the Learning and Academic Advising Center, the Vice President for Student Affairs or the Vice President for Business Affairs.


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