TRANSFER APPLICATION

THE UNIVERSITY OF NORTH CAROLINA AT PEMBROKE

UNDERGRADUATE ADMISSIONS APPLICATION

All Applicants

I. The application is to be completed in detail. Omission of any item will delay processing. Please type or print legibly in ink. Your failure to provide complete, accurate, and truthful information on this application will be grounds to deny or withdraw your admission, or dismiss you after enrollment.

II. When completed, return to UNCP, Office of Undergraduate Admissions, One University Drive, P.O. Box 1510, Pembroke, NC 28372-1510. For more information regarding the admissions process, call 910.521.6262 or 800.949.UNCP or fax us at 910.521.6497.

E-mail us at [email protected] or visit our web page at http://www.uncp.edu/admissions/undergraduate.

III. Social Security numbers are optional and are used solely to help identify students' records within our information processing system. IV. A $45 non-refundable fee must accompany this application.

V. Submit the application prior to the following priority deadlines: July 15 - Fall Semester; December 1 - Spring Semester; May 15 - Summer I Session; and June 15 - Summer II Session for adequate processing time.

VI. You can apply online if more convenient. Click on www.uncp.edu/admissions/apply/default/asp.

Supporting Documents

I. Transcripts

Official transcripts of all previous academic work must be sent to the University. (To be official, a transcript must display the school seal and be mailed directly from the high school or college to the Office of Undergraduate Admissions.) Faxed copies will be accepted as official if received from the appropriate school.

II. Aptitude Tests

All transfer class candidates must submit scores from either the College Board (SAT I) or the American College Testing Program (ACT) if you are under age 21 or have less than 24 transfer credit hours with a GPA of “C” or better. To request your official SAT I results, write to College Board, APT, Box 592, Princeton, NJ 08514. (See the application checklist for all the required documents.)

North Carolina Residency

A. Under North Carolina law, bonafide legal residents (domiciliaries) of North Carolina are eligible for a lower tuition rate than non-residents. Copies of the applicable law and of implementing institutional regulations are available for inspection in the Mary Livermore Library and may be examined upon request. In essence, the controlling North Carolina statute (G.S. 116-143.1) requires that "to qualify for in-state tuition a legal resident must have maintained his domicile in North Carolina for at least 12 months immediately prior to his classification as a resident for tuition purposes." Neither a foreign national nor an alien admitted on a student visa is eligible for the in-state tuition rate. An alien holding a visa, which will permit permanent residence in the United States is subject to the same considerations as a citizen. If residence is questionable, completion of an application for residency may be required. Determinations of residency

for tuition purposes are made based on a preponderance of the evidence relevant to intent to maintain permanent legal residence.

B. Military members and dependents stationed in North Carolina may be eligible for an In-State Tuition Waiver. To be considered for this, the student must submit a military waiver form. Applicants may view or print the residency or waiver form at the following link: http://www.uncp.edu/admissions/undergraduate/residency/default.asp.

International Students

International students should request and complete the UNC Pembroke Undergraduate Application for International Students. Details regarding the completion and submission of applications for international students are available at this link: http://www.uncp.edu/admissions/undergraduate/international.

Health Forms & Housing

Prior to enrollment, all students registered for five or more semester hours must submit a completed health form to the Student Health Services office. This application for

admission does not reserve a residence hall room. A housing application is available to accepted students at http://www.uncp.edu/housing/agreement.htm. Questions concerning housing should be directed to Housing and Residence Life Office at 910.775.4253.

THE UNIVERSITY OF NORTH CAROLINA AT PEMBROKE

UNDERGRADUATE ADMISSIONS

State Codes

American Indian Studies

American Indian Studies

Art

Art

Art Education (K-12)

Biology

Biology (Environmental Track) Biology

Biology (Botany Track) Biology (Molecular Track) Biotechnology

Biology (Zoology Track) Biology: Biomedical Emphasis Environmental Science Biology: Medical Technologies Science Education: Biology

Business Administration

Accounting

Business Administration: Management Business Administration: Economics Business Administration: Economics Online Business Administration: Finance Online Business Administration: Finance Business Administration: International Business Administration: Information Technology

Business Administration: Management Business Administration: Marketing

Chemistry & Physics

Applied Physics Forensic Track

Chemistry (Professional Track) Chemistry

Chemistry (Molecular Track) Environmental

Medical Technology Pre-Health Profession Pre-Pharmacy

Science Education: Chemistry Science Education: Earth Science Science Education: Physics

ENGE ENG THE LESL BIS SPN LSPN BKED *BKEDL ELEM MGLA MGMA MGS MGSS SPED LPRK LAIG PATH EXPH HLTP PED RECM SMGT AST HST SSE MBRD MJRN MPUB

English & Theatre

English: English Education English: English

Theatre ESL Add-on

Interdisciplinary Studies

Interdisciplinary Studies* * Only available to Applied Associate degree holders

Languages

Spanish

Teacher Licensure in Spanish (K-12)

Education

Birth-Kindergarten Birth-Kindergarten Online Elementary Education: K-6

Middle Grades Education: Language Arts Middle Grades Education: Mathematics Middle Grades Education: Science Middle Grades Education: Social Studies Special Education

Preschool Add-on AIG Add-on

Health, Physical Education & Recreation Athletic Training Exercise Physiology Health Promotion Physical Education (K-12) Recreation Management Sport Management History American Studies History

History: Social Studies Education

Mass Communication

Mass Communication: Broadcasting Mass Communication: Journalism Mass Communication: Public Relations

CSC MAT MATE ITC KEYI MUS MUSB MUSI MUSK MUST MUSV PREN NURS P&R INTS PADM PLAW PLS PSY CRJ *CRJL SOC *SOCL SWK UND

Mathematics & Computer Science

Computer Science Mathematics

Mathematics Education Information Technology

Music

Music Education: Keyboard Instrumental Music

Music: Elective Studies in Business Music Education: Instrumental Music Education: Keyboard (Vocal) Music: Musical Theatre

Music Education: Vocal

Nursing

Pre-Nursing Nursing (RN to BSN)

Philosophy & Religion

Philosophy & Religion

Political Science

Political Science: International Studies Political Science: Public Administration Political Science: Pre-Law

Political Science

Psychology & Counseling

Psychology

Sociology & Criminal Justice

Criminal Justice Criminal Justice Online Sociology Sociology Online Social Work Social Work Undecided Undecided 2

Reference Codes

Use the appropriate codes to complete the application.

*Online programs are Degree Completion Programs only. You cannot complete a degree completely online. Completion of general education requirements and prerequisites are necessary for admission into online degree completion programs.

UNCP Undergraduate Admissions Transfer Application

*Note: The most up-to-date application is available through applying online at www.uncp.edu/admissions/apply/default.asp.

Entering Term:

_______Fall _______Spring _______ Summer 1 _______ Summer 2 Entering Year 20________

Name _______________________________________________________________________________________________________________________________________ SS# ____________________________ Last Name First Middle Optional: For Id purposes only* Have you attended another university under another name? yes no If yes, please list prior name______________________________________.

Mailing Address

__________________________________________________________________________________________________________________________

Number Street P.O. Box Number

_________________________________________________________________________________________________________________________________________________________________________________________ City County State Zip Code(9 digits)

Permanent Address

_______________________________________________________________________________________________________________________

(if different from above) Number Street P.O. Box Number

___________________________________________________________________________________________________________________________________________________________ City County State Zip Code(9 digits)

Current Telephone(______) _____________________________Work Telephone (if applicable) (_______)________________________Cell Phone (_______) ________________________________ Email: ______________________________________________________________________________________

Gender: ______Male ______Female Date of birth: _______________________________ Place of birth:_____________________________________

Citizenship: ______C=USA ______ R=Permanent resident alien ______N=Non-immigrant alien Country _______________________________

Are you Hispanic or Latino? yes no Select one or more of the following racial categories: _____ American Indian/Alaska Native ____________________________ ______Asian

_____ Black or African American (tribe) ______Native Hawaiian _____ White or Pacific Islander ______Other

Major Code ________ Athletic Interest ____________________ Artistic Interest ____________________ Other Interest ____________________

Military status:(indicate current status) place a _______Active duty ______National Guard _______Reservist ______Veteran ______Dependent ______Not applicable Have you been in active military service or have you been a military dependent in the past 12 months? yes no

EDUCATION

List all high schools you have ever attended for any length of time, whether or not you have completed a term:

Name of High School City State Dates Attended Year Graduated

*Disclosure of the applicant’s Social Security number is voluntary and is requested here by UNCP solely as an internal identifier for record-keeping accuracy.

Please be aware that financial aid, employment and reporting of tuition and related expenses for tax purposes cannot be processed without submission of a valid Social Security number.

Are you applying on the basis of an Adult High School Diploma or a GED Certificate? ________________________________________________________________________________________________ .

Have you ever applied to The University of North Carolina at Pembroke? ________ If yes, when? ________________________________________________________ . Have you ever attended The University of North Carolina at Pembroke? ________ If yes, when? ________________________________________________________.

List all colleges/universities you have ever attended for any length of time, whether or not you have completed a term (list most recent first

Name of College/University City State Dates Attended Degrees and Year

How did you first learn about the University? (Please mark one ONLY)

____Billboard ____Radio ____Television ____Cinema ____Magazine ____College Fair ____Friends

____Alumni ____Counselor ____Newspaper ____Internet ____Mail ____UNCP faculty or staff member ____Other

Are you a legal resident of North Carolina? yes no Since what date? ________________________________________________________ month/day/year

Tuition Benefits Notice

North Carolina provides certain tuition benefits to spouses of North Carolina residents, active military members who are stationed in North Carolina, spouses and dependents of active duty military personnel stationed in North Carolina, members of the North Carolina National Guard, and family members of deceased or disabled emergency workers. If you believe you qualify for these benefits, you should contact the Office of Undergraduate Admissions for an appropriate form, or print a copy from this link:

http://www.uncp.edu/admissions/residency/.

When you have completed the appropriate form, please submit it to the Office of Enrollment Planning and Recruitment.

The University of North Carolina at Pembroke, Office of Enrollment Planning and Recruitment, P.O. Box 1510,Pembroke, North Carolina 28372-1510. Phone: 910. 522.5800 Fax: 910. 775.4158

Military Status for Financial Aid and Residency Determination

a. Are you currently serving or have you ever served in the United States Armed Forces?

b. Are you a dependent or spouse of a current or prior United States service member?

If you answered ‘yes’ to question (a) please answer the following:

Please complete the following if you currently serve or have ever served in any branch or status in the United States Armed Forces. This information will help us connect you with financial aid benefits and determine your eligibility for in-state residency.

1. Your current status ________________ . The answers allowable under this heading shall be: Active-duty, NC National Guard, Other National Guard, Reservist, Separated Veteran, Retiree. 2. Branch of service ______________________________ The answers allowable under this heading shall be: Army, Air Force, Navy, Marine Corps, Coast Guard.

3. Current or last pay grade____________. The answers allowable under this heading shall be: 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 educational benefits while enrolled at this institution? __________. The answers allowable under this heading shall be:Yes, No, Not Sure. 5. If yes, which benefit do you plan to use? ________________________________________ The answers allowable under this heading will be:

Chapter 30 - Montgomery GI Bill Chapter 31 - Vocational Rehabilitation Chapter 33 – Post 9/11 GI Bill

Chapter 35 – Dependents Education Assistance (DEA) Chapter 1606 – Selected Reserves GI Bill

Chapter 1607 – Reserves Education Assistance Program (REAP) Military Tuition Assistance

Military Spouse Career Advancement Accounts (MyCAA) Marine Gunnery Sgt. John David Fry Scholarship Not sure

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****THIS SECTION IS TO BE COMPLETED BY ALL APPLICANTS*****

The following information is necessary to determine your residency for tuition purposes.

Last address outside of North Carolina From       To Month/Day/Year Month/Day/Year

1. Your current or last permanent duty station _________________________________________________________ The answers allowable under this heading shall be: 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.

2. Your current or last home of record ______________________________________________________________________________________. 3. Your state of legal residence last claimed on your DD Form 2058 (State of Legal Residence Certificate) __________.

4. Date of initial entry into military service ____________________.

5. Discharge or retirement date (actual or anticipated)___________________________.

6. If discharged or retired, your final duty station ________________________. The answers allowable under this heading will be: Fort Bragg, Camp Lejeune, MCAS Cherry Point, MCAS New River, Pope AFB, 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 answer the following:

Please complete the following if you are the dependent or spouse of someone currently serving or who has ever served in any branch or status in the United States

Armed Forces. This information will help us connect you with financial aid benefits and determine your eligibility for in-state residency.

Please respond to these questions in reference to the connected service member.

1. Your relationship to the service-member or veteran_____________________. The answers allowable under this heading shall be: dependent, spouse.

2. Current Status of Service Member _________________________. The answers allowable under this heading will be: Active-duty, NC National Guard, Other National Guard, Reservist, Separated Veteran, Retiree.

3. Branch of Service of Service Member ____________________. Army, Air Force, Navy, Marine Corps, Coast Guard.

4. Current or Last Pay Grade of Service Member __________. The answers allowable under this heading will be: 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 United States Department of Defense or veterans educational benefits while enrolled at this institution? __________. The answers allowable under this heading will be: Yes, No, Not Sure

6. If yes, which benefit do you plan to use? ________________________________________.The answers allowable under this heading will be: Chapter 33 – Post 9/11 GI Bill

Chapter 35 – Dependents Education Assistance (DEA) Military Spouse Career Advancement Accounts (MyCAA) Marine Gunnery Sgt. John David Fry Scholarship Not sure

1. Current or last permanent duty station of service member ______________________________. The answers allowable under this heading will be: 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

2. Current or last home of record of service member __________________________________________.

3. What is/was state of legal residence the service member last claimed on his/her DD Form 2058 (State of Legal Residence Certificate)? ____________________ 4. Date of initial entry into military service for service member ____________________.

5. Discharge or retirement date of service member (actual or anticipated)____________________.

6. If discharged or retired, service member’s final duty station ____________________. The answers allowable under this heading will be: Fort Bragg, Camp Lejeune, MCAS Cherry Point, MCAS New River, Pope AFB, Seymour Johnson AFB, USCG North Carolina, Other installation outside of NC, NA - NC National Guard, NA - Other National Guard, NA – Reservist

Personal Statement

In your own words, tell us why you want to attend The University of North Carolina at Pembroke. Include special academic, athletic, artistic and/or leadership interests. You are encouraged to use a separate sheet of paper if necessary. Student resumes are welcome.

Campus Safety Questions

In an effort to maintain a safe learning community, we must ask the following questions of all applicants. For the purpose of the following questions, “crime” or “criminal charge” refers to any crime other than a traffic related misdemeanor or an infraction. You must, however, include any alcohol or drug related offenses whether or not they are traffic related incidents. Answering “yes” to any of the following questions may not necessarily preclude your being admitted. However, failing to answer these questions, or failing to respond completely, accurately, 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 each incident, explains the circumstances, and reflects on what you learned from the experience. The university reserves the right to require an additional statement from an appropriate official corroborating your account, either before acting on your application or before permitting you to enroll. Your failure to provide such 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 criminal charge, any disposition of a criminal charge, or any school, college, or university disciplinary action against you, or any type of military discharge other than an honorable discharge, or any non-routine absence from school, that occurs at any time after you submit this application 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. Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal, or expulsion from the institution? Yes No

2. Have you ever been adjudicated guilty or convicted of a misdemeanor, felony, or other crime? Yes [Note that you are not required to answer “yes” to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise ordered by a court to be kept confidential.] 3. Do you have any criminal charges pending against you? Yes No

4. Have you entered a plea of no contest or nolo contendere, or an Alford plea, to a misdemeanor, felony, or other criminal charge; or received a deferred prosecution or prayer for judgment continued for such a charge; or otherwise accepted responsibility for such a crime? Yes No

5. Have you received any type of discharge from military service “other than an honorable discharge”? Yes

No - Never Served No - Currently Serving No - Honorably Discharged

6. If your education was or will be interrupted, indicate here and provide details in additional information section.

Additional information____________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________

If you answered "yes" to any of the six questions above, please explain the circumstances below (or on a separate sheet, if necessary).

___________________________________________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________ You are required to notify the university immediately and in writing of any new or pending criminal charge, any disposition of a criminal charge, or any school, college, or university disciplinary action against you, or any type of military discharge other than an honorable discharge, or any non-routine absence from school, that occurs at any time after you submit this application and prior to enrollment. Your failure to do so may be grounds to deny or withdraw your admission or to dismiss you after enrollment. By signing this application, you are granting permission for a criminal background check if deemed necessary.

I UNDERSTAND THAT WITHHOLDING INFORMATION requested in this application or giving false information may make me ineligible for admission to/or continuation at The University of North Carolina at Pembroke. With this in mind, I certify that the statements herein are correct and complete. I understand my failure to provide complete, accurate, and truthful information on this application will be grounds to deny or withdraw my admission, or dismiss me after enrollment.

____________________________________________________________________ _________________________________________________________________ Signature Date Parent or Guardian’s signature Date (If applicant is under 18 years of age)

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A $45(U.S.) non-refundable application fee must accompany the application. Please return to: The University of North Carolina is committed to equality of educational opportunity and does not discriminate against applicants, students, or employees based on color, national origin, religion, sex, age, or handicap. Moreover, The University of North Carolina at Pembroke is open to all people of all races.

The University of North Carolina at Pembroke

Office of Undergraduate Admissions PO Box1510

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Application Checklists

Submit all required documents:

Application Priority Deadlines

Fall Semester . . . July 15 Spring Semester . . . December 1 Summer 1 Session . . . May 15 Summer 2 Session . . . June 15

UNC Pembroke Codes:

SAT Code . . . 5534 ACT Code . . . 3138 FAFSA Code . . . 002954

Please note: No financial aid award is made until:

(1) the student is accepted to The University of North Carolina at Pembroke and (2) A Free Application for Federal Student Aid (FAFSA) form has been completed and processed.

This publication is available in alternative formats upon request. Please contact Disability Support Services, DF Lowry Building, 521-6695. 5,000 copies of this public document were printed at a cost of $0.30 per copy.

For Transfer Students

______ Completed UNCP application _______$45(U.S.) non-refundable application fee

_______ Official high school transcript(s) _______ Transcripts from ALL institution(s) attended _______ Completed university questionnaire (last page)

Mail your completed application and required documents to: The University of North Carolina at Pembroke

Office of Undergraduate Admissions P.O. Box 1510

Pembroke, NC 28372-1510

University Questionnaire

(to be completed by transfer students only)

This questionnaire is to be completed by the last college/institution you attended. Applicant must complete the top section and complete the signature block. The Dean of Students of that institution will complete the remainder and return by mail or fax this form to the Office of Undergraduate Admissions at The University of North Carolina at Pembroke.

Name ________________________________________________________________________________________________________ Date of Birth_____________________________________ Address ____________________________________________________________________City______________________________________State ____________Zip______________________ College Attended ________________________________________________________________________________________________________________________________________________ Dates of Attendance ___________________________________________________ to_______________________________________________________________________________________

the requested information and any other information you may have concerning me to the above mentioned university. ____________________________________________________________________________________ Signature of Applicant Date

To the Dean of Students:

The student listed above is making application for admission to The University of North Carolina at Pembroke. In addition to the requested information, we would be grateful for any other information you have which you believe may be helpful to us when the application is reviewed.

1. Has the student been disciplined, placed on probation or suspended for (a) academic reasons__________ (b) conduct reasons __________ (c)other reasons __________

If your answer to a, b, or c is yes, please explain. _______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________ 2. Would the student be permitted to re-enter your institution next semester/quarter? Yes_____________ No _____________

If no, please specify the reason. ______________________________________________________________________________________________________________________________ Other comments: _____________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________

Return this questionnaire to: Please Print or Type:

The University of North Carolina at Pembroke Name_______________________________________________________

Office of Undergraduate Admissions Signature____________________________________________________

P.O. Box 1510 Position/Title_________________________________________________

Pembroke, NC 28372 Date__________________________ Phone_________________________

Fax: (910)521-6497 Email_______________________________________________________