New Student Application(Undergraduate Program)

ADMISSION APPLICATION
UNDERGRADUATE ADMISSIONS

PERSONAL INFORMATION

Male Female

Social Security Number:

JMVU ID Number:

Full Name: - -

Other Names Used (if applicable):

Permanent Address:

Place of Birth:

Nationality:

Date of Birth:

M/d/yyyy

Telephone:

Cell Phone:

Email:

Have you ever applied to JMVU? YES NO

Are you a JMVU employee? YES NO

Are you a U.S. citizen? YES NO

Are you a Florida resident? YES NO

Is English your first language? YES NO

Ethnic Group:
Hispanic	White (not of Hispanic origin)	Black (not of Hispanic origin)	Asian
American Indian or Native Alaskan	Other (please specify):

Employment Status:
Full time	Part-time	Unemployed

Job Title:		Phone Number:
Employer Name:		Fax Number:
Address:

Emergency Contact:

ADMISSION INFORMATION

Indicate when you plan to begin: Year

Indicate when you plan to finish: Year

Semester:

Check one:
Day Program	Afternoon Program	Evening Program	Weekend Program

Choose one program:

You will receive or have received your high school education via:
High School Graduation	GED	Home School

High School Name:

Cumulative GPA:

High School Graduation Date:

State or Country:

General Education Diploma (GED) awarded:

SAT Scores(optional) - - -

ACT Scores(optional) - - - -

ADMISSION REQUIREMENTS

High School or GED Diploma (*)
High School or GED Transcripts (*)
Non-refundable application fee
Provide Government Issued ID

*Graduated in the United States: Provide a copy of the original High School Diploma, and contact your High School / University to send official Transcripts in a sealed envelope to JMVU.

*Graduated out of the United States: Provide translation of High School Diploma and Transcripts from a company authorized by the National Association of Credential Evaluation Services (NACES)

JUDICIAL INFORMATION

Have you ever been subject to disciplinary action or do you currently have disciplinary charges pending by any educational institution for any of the following reason?

Academic misconduct (plagiarism) YES NO

Behavioral misconduct (such as fighting) YES NO

Have you ever been convicted in any state or country of a criminal offense, other than a minor traffic offense, where you have been found guilty by a judge or jury or entered a plea of nolo contendere (no contest): or any juvenile offenses; any offenses where the records have been expunged; or any conviction that the applicant is currently appealing, regardless of adjudication?

YES NO

ALL APPLICANTS

I understand that this application is for admission to José María Vargas University. I also understand and agree that I will be bound by the regulations of the University concerning admissions requirements. I further agree to the release of any transcripts to this institution.
I certify that the information given in this application is complete and accurate, and I understand that making false or fraudulent statements in this application may result in disciplinary action, denial of admission and invalidation of credits or degrees earned. Should any of the information I have given change, I shall immediately notify the Office of Admissions.
Signature of Student	Date	Signature of Guardian / Legal Representative
		Signature of Receiving Admissions Official

OFFICIAL USE ONLY

DATE OF APPLICATION:

FIRST DAY OF CLASS:

LAST DAY OF CLASS:

DATE PROCESSED:

PROCESSED BY: