residency and citizenship - ohio university · 2019. 7. 30. · bs6177 mathematics and science...

Residency and Citizenship

What is your country of citizenship?

If you did not answer “United States” in the above question, are you a U.S. permanent resident? Yes No

Are you an international student? Yes No

Do you currently hold a U.S. visa? Yes No

If yes, what type of visa do you currently hold?

Where were you born? City CountryIf you were not born in the U.S. but are a U.S. Citizen or Permanent Resident, please submit proof of this status.

Are you an Ohio resident? Yes No

Since what date have you been an Ohio resident?

What is your county of residence?

Where were you born? City State CountryIf you were not born in the U.S. but are a U.S. Citizen or Permanent Resident, please submit proof of this status.

Permanent Address

Street Address 1

Street Address 2 City State

/ /Zip/Postal Code County Country (if not U.S.) Address Valid Since mm / dd / yyyy

Mailing Address Check if same as above

Street Address 1

Street Address 2 City State

/ /Zip/Postal Code County Country (if not U.S.) Address Valid Since mm / dd / yyyy

Home Phone Cell Phone (Area Code) Phone Number (Area Code) Phone Number

Email Address NOTE: This address will be used for correspondence from Ohio University. Please notify Student Services if this e-mail address changes.

Ethnic Background

This information is optional and will not be used for discriminatory purposes.

Are you Hispanic or Latino? Yes No

Select one or more of the races from the list below:

American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White

2

Military Status

Are you currently serving on active duty in the U.S. Armed Forces for purposes other than training? Yes No

Are you a veteran of the U.S. Armed Forces? Yes NoFor purposes of the following questions, a veteran is defined as an individual who (1) has engaged in active duty in the U.S. Armed Forces (Army, Navy, Air Force, Marines or Coast Guard) or is a National Guard or Reserve enlistee who was called to active duty for other than state or training purposes, or was a cadet or midshipman at one of the service academies, and (2) was released under a condition other than dishonorable. Also answer “Yes” if these conditions do not apply now but will apply by June 30, 2011. An individual should answer “No” if he/she (1) has never engaged in active duty in the U.S. Armed Forces, (2) is currently an ROTC student or cadet or midshipman at a service academy, (3) is a national Guard or Reserve enlistee activated only for state or training purposes, or (4) was engaged in active duty in the U.S. Armed Forces but released under dishonorable conditions.

Is your parent, step-parent, or legal guardian a veteran of the U.S. Armed Forces? Yes No

Is your spouse a veteran of the U.S. Armed Forces? Yes No

Are you a member of the National Guard or the U.S. Armed Forces reserve? Yes No

Emergency Contact Information

Name Last First

Address Number and Street 1 Apartment#

Number and Street 2 Apartment#

City State/Province Zip/Postal Code

County Country (if not U.S.)

Phone Number Phone Type Home Work Cell

Relationship Mother Father Step-Father Step-Mother Legal Guardian Spouse Other

Family Information

Will you be the first in your family to go to college? Yes No

If your parents are divorced or separated, please respond to these questions about the parent(s) you lived with more during the past twelve months, even if one

is a step-parent.

Parent/Guardian 1

Highest level of school this parent or guardian has completed

Less than HS Graduate HS Graduate or Equivalent Some College Technical 2-Year College Degree Bachelor’s Level Degree

Some Graduate School Master’s Level Degree Doctorate (Academic) Doctorate (Professional) Post-Doctorate

Did this parent or guardian graduate from Ohio University? Yes No

Is this parent or guardian an employee of Ohio University? Yes No

Name Last First

Email Address


Relationship

Mother Father Step-Father Step-Mother Legal Guardian Other

[Family information continued on next page]

3

[Family information continued from previous page]

Parent/Guardian 2

Highest level of school this parent or guardian has completed

Less than HS Graduate HS Graduate or Equivalent Some College Technical 2-Year College Degree Bachelor’s Level Degree

Some Graduate School Master’s Level Degree Doctorate (Academic) Doctorate (Professional) Post-Doctorate

Did this parent or guardian graduate from Ohio University? Yes No

Is this parent or guardian an employee of Ohio University? Yes No

Name Last First

Email Address


Relationship

Mother Father Step-Father Step-Mother Legal Guardian Other

Do you have family members who have attended, or are currently attending, Ohio University? Yes No

Relationship

Name Last First

Relationship

Name Last First

Relationship

Name Last First

Relationship

Name Last First

Your Education

High School Information High School Type: Public Private Home School

Name

City State/Province CEEB Code

Graduation Date

GED? Yes No

State

Standardized Tests

Please provide the date you took, or plan to take, standardized tests.You must submit ACT or SAT test results unless you have been out of high school for more than one year. Scores must be received directly from the testing agency.

ACT Test Date

ACT Test Date

4

Education History

Have you ever taken Ohio University coursework (regardless of location or level)? Yes No

Have you attended any other colleges or universities? Yes No

Have you ever been dismissed or suspended from high school or another college/university? Yes No

Date of Dismissal/Suspension

Name of Institution

Disciplinary Academic

Have you ever been found responsible for a disciplinary violation at any school you have previously Yes Noattended?You should answer yes to the above question if, at any time, you have been found responsible for any disciplinary violation at your school, whether related to academic misconduct or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal, or expulsion from your institution.

If yes, please attach an explanation.

Are there any unresolved judicial charges still pending at any of your previous institutions? Yes NoIf yes, please attach an explanation.

Are you eligible to return to every institution you have previously attended? Yes NoIf no, please attach an explanation.

List ALL other colleges/universities attended prior to enrolling at Ohio University. If you enroll at another institution after submitting this application you must notify Undergraduate Admissions of that institution. Indicate dates of attendance and degrees earned if applicable.

Name

City State/Province Country

Beginning Date of Attendance

End Date of Attendance

Degree Earned Date Degree Received/Expected

Name





Name





Signature Date / /

I understand that I am responsible for submitting complete and accurate information on my application form and in all related application materials. I certify that the information contained in this application form and in all application materials is complete and accurate, and I understand that submission of inaccurate information by me or at my direction may be sufficient cause for terminating my enrollment.

Student Name Date Completed

PLEASE RETURN THIS APPLICATION WITH THE $20 NONREFUNDABLE APPLICATION FEE TO THE STUDENT SERVICES OFFICE OF THE REGIONAL CAMPUS YOU ARE APPLYING TO BELOW

It is the policy of Ohio University that there shall be no discrimination against any individual in educational or employment opportunities because of race, religion, color, sex, sexual orientation, national origin, ancestry, age, gender identity or expression, mental or physical disability, or veteran status. Ohio University is an affirmative action institution. The following person has been designated to handle inquiries regarding the nondiscrimination policies: Executive Director Laura L. Myers, J.D., M.A., C.A.A.P., Office for Institutional Equity, 1 Ohio University, Athens, Ohio 45701, Telephone: 740.593.9132.

Ohio University Chillicothe101 University DriveChillicothe OH 45601www.ohio.edu/chillicothe740.774.7200

Ohio University Zanesville1425 Newark RoadZanesville OH 43701www.ohio.edu/zanesville740.588.1439

Ohio University Eastern45425 National RoadSt. Clairsville OH 43950www.ohio.edu/eastern740.699.2536

Ohio University Lancaster1570 Granville PikeLancaster OH 43130www.ohio.edu/lancaster740.654.6711

Ohio University Southern1804 Liberty AvenueIronton OH 45638www.ohio.edu/southern740.533.4600

5

Regional Campus Degrees

MAJOR CODE LIST

The two-letter prefix of each major code indicates the type of degree awarded in that major. In some cases, it indicates that an additional application process is required for admission to the major.

Chillicothe BS5511 Applied Management2

AA1104 Arts and Humanities Emphasis A15508 Associate in Individualized Studies3

AS1104 Associate in Science AA5006 Business Management Technology AA1106 Child Development BC5364 Communication Studies3

AA5010 Computer Science Technology BC2209 Criminal Justice1

AA5018 Environmental Engineering Technology BS8119 Health Services Administration AA5201 Human Services Technology AA5505 Law Enforcement Technology AA5014 Office Technology ND8837 Pre-Early Childhood Education6

ND1220 (bachelors) Pre-Nursing, BSN3 ND8833 (associates) Pre-Nursing, RN3

ND6603 Pre-Social Work7 AA1110 Social Science Emphasis BS1112 Specialized Studies2 BT5510 Technical and Applied Studies4

ND1201 Undecided5

Middle Childhood Education BS6180 Language Arts and Mathematics BS6179 Language Arts and Science BS6178 Language Arts and Social Science BS6177 Mathematics and Science BS6175 Mathematics and Social Sciences BS6176 Science and Social Studies

Eastern BS5511 Applied Management2

AA1114 Arts and Humanities Emphasis AS1104 Associate in Science A15508 Associate in Individualized Studies3

BC5364 Communication Studies BS8105 Community Health Services BC2209 Criminal Justice1 BS8119 Health Services Administration BA4211 History ND8837 Pre-Early Childhood Education6

ND8839 Pre-Exercise Physiology6

ND6603 Pre-Social Work7 AA1110 Social Science Emphasis BS1112 Specialized Studies2 BT5510 Technical and Applied Studies4

ND1201 Undecided5


Lancaster AA5002 Accounting Technology BS5511 Applied Management2

AA1114 Arts and Humanities Emphasis A15508 Associate in Individualized Studies3

AS1104 Associate in Science AA5006 Business Management Technology AA1106 Child Development BC5364 Communication Studies AA5010 Computer Science Technology BC2209 Criminal Justice1

AA5003 Deaf Studies and Interpreting AA5013 Electronic Media BS8119 Health Services Administration BA4211 History AS5201 Human Services AA5020 Industrial Maintenance Technology AA5505 Law Enforcement Technology AA5019 Medical Assisting Technology ND8837 Pre-Early Childhood Education6 ND6603 Pre-Social Work7

AA1110 Social Science Emphasis BS1112 Specialized Studies2 BT5510 Technical and Applied Studies4

ND1201 Undecided5


Southern AA5002 Accounting Technology BS5511 Applied Management2

AA1114 Arts and Humanities Emphasis AI5508 Associate in Individualized Studies3 AS1104 Associate in Science AA5006 Business Management Technology AA1106 Child Development BC5364 Communication Studies AA5010 Computer Science Technology BC2209 Criminal Justice1 AA5013 Electronic Media AA5017 Equine Studies BS8119 Health Services Administration AA5022 Health Technology BA4211 History AA5201 Human Services Technology AA5505 Law Enforcement Technology BS6836 Long-Term Health Care Administration ND8833 (associates) Pre-Nursing, RN3

AA5014 Office Technology ND8837 Pre-Early Childhood Education6 ND1220 (bachelors) Pre-Nursing, BSN3 ND6603 Pre-Social Work7

AA1110 Social Science Emphasis BS1112 Specialized Studies2 BT5510 Technical and Applied Studies4

ND1201 Undecided5


Zanesville BS5511 Applied Management2

AA5013 Associate in Electronic Media AA1114 Associate in Humanities AI5508 Associate in Individualized Studies3

AS1104 Associate in Science AA1110 Associate in Social Science BC5364 Communication Studies BC2209 Criminal Justice1

BS8119 Health Services Administration BA4211 History ND8833 (associates) Pre-Nursing, RN3

ND8837 Pre-Early Childhood Education6

ND1220 (bachelors) Pre-Nursing, BSN3 ND6603 Pre-Social Work7

BS1112 Specialized Studies2 BT5510 Technical and Applied Studies4

ND1201 Undecided5


Footnotes for regional majors

1. Requires an associate degree in an area related to criminal justice. Separate application required. Not open to freshmen.

2. Separate application required. Not open to freshmen.

3. Separate application required.

4. Associate degree in technical field required.

5. See footnote 19 on page 8.

6. See footnote 3 on page 8.

7. See footnotes 11 and 12 on page 8.

AA Associate in Arts AAS Associate in Applied Science AS Associate in Science BA Bachelor of Arts BB Bachelor of Business Administration

BC Bachelor of Science in Communication BF Bachelor of Fine Arts BJ Bachelor of Science in Journalism BM Bachelor of Music BS Bachelor of Science

ND Non-degree or undecided (sometimes used to indicate that a pre-major program is required prior to direct admission to the major) SA Additional action required

6

Athens Campus

MAJOR CODE LIST

COLLEGE OF ARTS AND SCIENCESSome of the majors in this college have two major codes. In general, with these majors you have the option of choosing either a degree program that is more science-oriented (BS) or one that is more liberal arts/humanities-oriented (BA). Details on curricular differences can be found in the College of Arts and Sciences section of the Undergraduate Catalog under the specific program listing. You may want to consult an admissions officer or a college representative about which option is more suitable for you.

African American Studies BA4903 African American Studies

Anthropology BA4252 Anthropology

Biological Sciences BS2121 Biological Sciences BS2520 Cellular and Molecular Biology BA2129 Environmental Biology BA2128 Human Biology BS2126 Marine, Freshwater, and Environmental Biology BS0411 Microbiology BS2127 Pre-Dentistry BS2127 Pre-Medicine BS2127 Pre-Optometry BS2507 Pre-Physical Therapy BS2127 Pre-Veterinary Medicine BS2522 Wildlife and Conservation Biology

Chemistry and Biochemistry BS3311, BA3311 Chemistry BS3316 Biochemistry BS3315 Environmental Chemistry BS3310 Forensic Chemistry BS3312 Pre-Dentistry BS3314 Pre-Medicine BS3313 Pre-Pharmacy

Classics and World Religions BA5214 Classical Civilization BA5215 World Religions BA5217 Classical Languages

Economics BA4221, BS4225 Economics

English BA5231 English

Environmental and Plant Biology BS2120 Environmental and Plant Biology BA2119 Field Ecology

Geography BS4231, BA4231 Geography BS4232 Environmental Geography BS4240 Environmental Pre-Law BS4235 Geographic Information Science BS4238 Meteorology BS4234 Urban Planning

Geological Sciences BS3321, BA3321 Geological Sciences BS3323 Environmental Geology

History BA4211 History BA4214 Pre-Law

International Studies BA4405 Global Studies – Africa BA4406 Global Studies – Asia BA4407 Global Studies – Europe BA4408 Global Studies – Latin America BA4409 Global Studies – War and Peace

Linguistics BA5290 Linguistics

Mathematics BS3101, BA3101 Mathematics BS3105 Actuarial Sciences BS3103 Applied Mathematics BS3110 Meteorology BS3106 Statistics

Modern Languages BA5221 French BA5222 German BA5224 Russian BA5225 Spanish

Philosophy BA5241 Philosophy BA5244 Pre-Law BA5242 Pre-Theology

Physics BS3331, BA3331 Physics BS3332 Applied Physics BS3335 Astrophysics BS3338 Meteorology

Political Science BA4201 Political Science BA4203 Pre-Law

Psychology BA4101 Psychology BA4105 Pre-Physical Therapy

Sociology BA4251 Sociology BA4253 Criminology BA4254 Pre-Law

Undecided ND0410 Undecided ND0406 Undecided-Humanities Preference ND0408 Undecided-Social Sciences Preference ND0407 Undecided-Natural Sciences Preference

Women’s Studies BA4402 Women’s and Gender Studies

COLLEGE OF BUSINESSThe Sport Management Major leads to the Bachelor of Sport Science. All other majors within the College of Business lead to the Bachelor of Business Administration.

BB6121 Accounting BB6124 Business Economics BB6120 Business Pre-Law BB6125 Finance BB6122 General Business BB6132 International Business BB6126 Management and Strategic Leadership BB6137 Management Information Systems BB6127 Marketing ND8840 Pre-Sport Management2, 3 ND0610 Undecided

SCRIPPS COLLEGE OF COMMUNICATION

Communication Studies BC5363 Communication and Public Advocacy BC5363 Organizational Communication BC5363 Health Communication

Information and Telecommunication Systems BC5329 Information and Telecommunication Systems

Journalism4

Transfer applicants may declare one of these tracks on the required supplemental application.4

BJ6906 News and Information BJ6907 Strategic Communication

Media Arts and Studies BC5365 Animation and Gaming Industry BC5365 Documentary and Social Change BC5365 Media Impact and Analysis BC5365 Music Production and Industry BC5365 Screenwriting and Producing BC5365 Video and Audio Production

Visual Communication4

BS6924 Informational Graphics/ Publication Design BS6923 Multimedia BS6922 Photojournalism BS6925 Commercial Photography

PATTON COLLEGE OF EDUCATION AND HUMAN SERVICES

Early Childhood AA1106 Child Development ND8837 Pre-Early Childhood3

Middle Childhood BS6175 Mathematics and Social Studies BS6176 Science and Social Studies BS6177 Mathematics and Science BS6178 Language Arts and Social Studies BS6179 Language Arts and Science BS6180 Language Arts and Mathematics

Adolescent to Young Adult (Secondary) BS6314 Life Science BS6315 Earth Science BS6306 Integrated Language Arts BS6307 Integrated Mathematics BS6309 Integrated Science BS6308 Integrated Social Studies BS6310 Physical Science

Multi-Age Programs BS6232 French BS6233 German BS6235 Spanish

Special Education BS6316 Special Education-Intervention Specialist Mild-Moderate Educational Needs5

BS6317 Special Education-Intervention Specialist Moderate-Intensive Educational Needs5

Recreation and Sport Pedagogy ND8838 Pre-Physical Education5

BS8156 Outdoor Recreation and Education BS8109 Recreation Management

Human and Consumer Sciences Education ND6380 Pre-Retail Merchandising and Fashion Product Development3

BS6370 Family and Consumer Sciences Education BS6361 Restaurant, Hotel and Tourism

Undecided ND0810 Undecided

7

Athens Campus

MAJOR CODE LIST

RUSS COLLEGE OF ENGINEERING AND TECHNOLOGY

Aviation AA7268 Aviation Technology BS7270 Aviation Management BS7269 Flight Option

Chemical and Biomolecular Engineering BS7251 Chemical Engineering BS7262 Chemical Engineering/ Materials track BS7263 Chemical Engineering/ Biological track BS7264 Chemical Engineering/Energy and the Environment track

Civil Engineering BS7252 Civil Engineering

Computer Science BS7260 Computer Science

Electrical Engineering BS7253 Electrical Engineering track BS7254 Electrical Engineering/Computer Engineering track

Industrial Systems Engineering BS7255 Industrial and Systems Engineering

Engineering Technology and Management BS7256 Industrial Technology includes minor in business

Mechanical Engineering BS7257 Mechanical Engineering

Undecided Engineering ND0910 Undecided

COLLEGE OF FINE ARTS

ArtFreshmen are admitted to one of the following Bachelor of Arts programs. These are direct entry programs that do not require a portfolio review. BA5050 Studio Art6

BA5149 Art History6

Admission to any specific art major leading to a Bachelor of Fine Arts is contingent upon a successful portfolio review at the end of the sophomore year. The following BFA programs are offered: Ceramics Graphic Design Interior Architecture7

Painting Photography Printmaking Sculpture

DanceA successful audition is required for all new freshmen and transfer students for admission to any major in dance. BA5150 Dance8

BF5154 Performance and Choreography6

MusicAuditions are required for all new freshmen and transfer students for admission into any major in music.The following code leads to a Bachelor of Arts in music and requires a successful entry-level audition: BA5195 Music8

The following codes lead to a Bachelor of Music degree and require a successful entry-level audition: BM5105 Music Composition9

BM5106 Music Education Choral Emphasis9

BM5107 Music Education Instrumental Emphasis9

BM5115 Music Therapy9

BM5104 Piano Pedagogy9

BM5100 Piano Performance9

BM5103 Orchestral Instruments9

BM5102 Organ Performance9

BM5101 Voice Performance9

TheaterAll applicants to the School of Theater apply using the Bachelor of Arts major code. This is a direct entry program that does not require an audition, interview or portfolio review: BA5194 Theater8

Admission to the specialized Bachelor of Fine Arts tracks is contingent upon an application and a successful audition, interview, and/or portfolio review at the end of the first year. The following BFA programs are offered: Stage Management6

Performance (Acting)6

Playwriting6

Production Design and Technology6

COLLEGE OF HEALTH SCIENCES AND PROFESSIONS

Applied Health Sciences and Wellness ND8142 Pre-Athletic Training10

ND8839 Pre-Exercise Physiology3

BS6363 Nutrition BS6360 Applied Nutrition

Social and Public Health BS6468 Child and Family Studies BS8105 Community Health Services BS6260 Environmental Health Science BS8119 Health Services Administration BS3309 Industrial Hygiene BS6836 Long-Term Health Care Administration ND6603 Pre-Social Work11, 12

Rehabilitation and Communication Sciences BS5305 Communication Sciences and Disorders (formerly Hearing, Speech, and Language Sciences) Physical Therapy13

NursingThis four-year program leads to the Bachelor of Science in Nursing degree (BSN) for students seeking initial licensure as a registered nurse (RN). ND1220 Pre-Nursing3

Undecided ND0210 Undecided

UNIVERSITY COLLEGE

Associate in Arts AA1114 Arts and Humanities Emphasis AA1110 Social Sciences Emphasis

Associate in Individualized Studies AI5508 Associate in Individualized Studies16

Associate in Science AS1104 Associate in Science

Baccalaureate Degrees BC2209 Bachelor of Criminal Justice17

BS1112 Bachelor of Specialized Studies16, 18

Undecided ND1201 Undecided19

Footnotes

1. Not open to transfer students.

2. This program leads to a Bachelor of Sport Science degree.

3. Selective admission program. Upon successful completion of the preparatory program requirements, you must complete a separate application for the major program and admission is not guaranteed.

4. Transfer applicants must follow the additional application process outlined on this school or department’s website.

5. Students admitted to this program must complete a separate application process during your first year of study before you will be eligible to register for any major-specific courses.

6. Selective admission program. This program leads to a Bachelor of Fine Arts degree.

7. Selective admission program. Upon successful completion of the preparatory program requirements, you must pass the portfolio review at the end of the freshman year to continue as an Interior Architecture major.

8. This program leads to a Bachelor of Arts degree.

9. Selective admission program. This program leads to a Bachelor of Music degree.

10. Selective program. Freshmen apply for full admission at the end of their first year. Transfers refer to instructions.

11. This pre-professional program does not fulfill any degree but is intended as preparation for admission into a professional school or program.

12. You must complete the Pre-Social Work Program and submit a separate application before you can become a social work major.

13. Not open to first-year students. Selective admission doctoral program. Major in a preparatory program such as Biological Sciences/Pre-Physical Therapy or Psychology/Pre-Physical Therapy in the College of Arts and Sciences, or Exercise Physiology in the College of Health Sciences and Professions. You must apply for the doctoral program through the School of Physical Therapy.

14. Undergraduate program in this area available only through HTC.

15. In general, the B.A. option provides a curriculum that is more liberal arts-oriented. You may want to consult an admissions advisor or a college representative regarding which option is more suitable for you.

16. Separate application required. Applicants must consult with a University College advisor or regional campus Student Services staff.

17. Requires an associate’s degree in an area related to criminal justice for admission. Not open to first-year students.

18. Not open to first-year students.

19. Students may remain undecided until they have earned 45 semester hours of credit. Transfer applicants are strongly encouraged to select a major program of study.

8Ohio University is an affirmative action institution.©2013 Ohio University. All rights reserved. UCM#1178 OUC:2.5M, OUE:2M, OUL:3M, OUS:3M, OUZ:2.5M

residency and citizenship - ohio university · 2019. 7. 30. · bs6177 mathematics and science...

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