Iowa Wesleyan College

Online & Evening Degree Application

First Name:

Last Name:
APPLICANT INFORMATION:
Middle Name:
Preferred Name:
Maiden Name:
Gender:
Male
Female
Permanent Address:
City:
Country:
State:
Canada:
Zip:
Date of Birth:
Social Security Number:
Are you a U.S. citizen or permanent resident?
Yes
No
If no, citizen of what country?
Type of Visa:
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Mailing Address:
City:
State:
Country:
Zip:
_______________________________________________________________________
Telephone Number(No hyphens):
Alternate Telephone Number:
Cell Phone Number:
Email Address:
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The items in this section are optional
Marital Status:
Single
Married
Divorced
Separated
Widowed
Other
Religious Affiliation:
Baptist
Catholic
Disciple of Christ
Jewish
Lutheran
Methodist
Presbyterian
Episcopal
Other
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Racial/Ethnic Information:
American Indian or Alaskan
Asian or Pacific Islander
Black/Non Hispanic
Hispanic
White/Non Hispanic
Other
Prinicipal language in home if other than English:
Please specify any special accommodations you have that should be brought to the attention of the College:
ADMISSIONS INFORMATION
I am applying as:
First year student
Transfer Student
Adult Learning
Former Iowa Wesleyan Student
Semester to begin:
Fall
Spring
Status:
Full-time
Part-time
Part-time evening
Intended Major:
Housing:
On-campus
Off-campus
Parent's home
Own residence
I have applied to the following colleges:
How did you learn about Iowa Wesleyan College?
Why did you apply to Iowa Wesleyan College?
What factors will be most important in your college decision?
Will you be filing the Free Application for Federal Student Aid (FAFSA) from?
Yes
No
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Name of Employer:
Current Position Held:
Work Phone Number:
I Work:
Full Time
Part Time
Other
I'm applying as:
Transfer Student
First-time College Student
Student holding a Bachelor's degree or higher
Degree Desired:
BA
BS
BSN
BGS
I plan to seek a degree from Iowa Wesleyan College:
Yes
I wish to renew my existing Teacher Licensure:
No
Yes
No
I wish to obtain a Teaching License:
Yes
No
I will be filing the Free Application for Federal Student Aid (If you desire financial aid, a FAFSA must be filed):
Yes
No
Please list Names, Locations and Dates of all previous schools attended (high schools, colleges, etc.):
Note: Persons seeking a degree or certification from Iowa Weseleyan College must submit transcripts of all previous college work. In some cases (including if you have no previous college credits) high school transcripts will be specifically requested.
I have previously applied for admission to Iowa Wesleyan College:
Yes
No
Please indicate how you heard about Iowa Wesleyan's evening degree completion program:
Children's names and ages (and colleges, if attended):
Please indicate what was your deciding factor to initiate pursuit of your college education through Iowa Wesleyan College:
Have you ever been charged with a violation of the law which resulted in probation, a jail sentence or the revocation or suspension of your driver's license?
If yes, please explain:
Current disposition of violation:
I authorize Iowa Wesleyan College to release news of my college acceptance to the media:
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