Alvernia College

ADMISSION APPLICATION

To apply for admission to Alvernia College, submit this form. A signature page will appear upon submission of this form. Return the page with a non-refundable $25.00 application fee to complete the application. Make check payable to Alvernia College.
ALVERNIA COLLEGE
400 Saint Bernardine Street, Reading, PA 19607
* 1-888-ALVERNIA * Fax (610) 796-8336

* Indicates that information or a choice must be supplied to complete the form.

* ADMISSIONS PROCEDURE - Please make one choice

Freshman Applicant   

Transfer Applicant

International Applicant

Additional Information


Have you previously applied for admission to Alvernia College?
No
Yes
If so, what semester/year?
Are you looking to attend school in the evening?
If Yes ,you may be interested in the various programs offered by our Division of Graduate and Continuing Studies. The office can be reached at (610) 796-8410
No
Yes

Title
Personal Data

Mrs. First Name:   Social Security Number:
Miss Middle Name: Date of Birth:
Ms. Last Name:
Mr. Maiden Name: U.S. Other
  Nickname (Additional documentation may be requested to supplement your application.)

Contact Information:

Street Address:
City:
State:
Zip Code:
County:
Phone Number: (Home)
Phone Number: (Work)
Email address:

Employer:

Company Name:
City/State

Sex:
Ethnic Origin:


Marital Status:


Religion:
Male
Female

American Indian/Alaskan Native

Asian / Pacific Islander

Black, Non-Hispanic

Hispanic

White / Caucasian

Unknown / Other

Single

Married

Divorced

Separated

Widowed

Catholic

Jewish

Protestant

Other

Unknown

Military Veteran:
Yes
No
Expected student status: Enrollment Term
Please indicate the semester and year you plan to enroll.
Full-Time
Part-Time     		Fall
Year
Resident
Commuter		 Spring

Educational History

High School (last attended)           
Dates Attended From To
City / State           
Graduation Date           
 * For high school equivalency in lieu of diploma, provide info for G.E.D. issuing agency.
College/Institution
(list all attended)
Location
(city/state)
Dates Attended
(include mo/yr)
Degree Earned
 
Credits
(Completed)
to
to
to
to

Do you have an associate degree?   
Yes
Degree
No

MAJOR - Please select one from the menu below.

FAMILY DATA    (Non-traditional applicants, provide emergency contacts.)


Father / male guardian / spouse's name
Relationship
Occupation
Company name / location
Home address (if different from student)
            Street Address
            City
            State
            Zip Code
 
Mother / female guardian / spouse's name
Relationship
Occupation
Company name / location
Home address (if different from student)
            Street Address
            City
            State
            Zip Code
 
Primary Emergency contact name
Primary Emergency contact phone
Secondary Emergency contact name
Secondary Emergency contact phone

HIGH SCHOOL / COLLEGE EXTRACURRICULAR ACTIVITIES AND SPORTS
(Not required for Non-Traditional Applicants)

Activity
I also plan on participating at Alvernia.
Activity
I also plan on participating at Alvernia.
Activity
I also plan on participating at Alvernia.
Activity
I also plan on participating at Alvernia.  

WHERE HAVE YOU HEARD ABOUT ALVERNIA COLLEGE?

Alumni Athletic Office Co-Worker College Fair
Friend Guidance Counselor Mailings Newspaper
Parents Radio Television Website
Other  

PERSONAL ESSAY
Alvernia College students are required to fulfill community service hours prior to graduation. In your own words, describe how your service will enable you to grow and develop both personally and professionally.

Upon submission of this application you will see a signature page for verification purposes.
Please print and mail in the page with a non-refundable $25.00 application fee.
Make check payable to Alvernia College.

Alvernia College complies with all federal, state, and local non-discrimination laws in the administration of its educational programs and services and in its employment relationships.


 

Updated: December 19, 2007