Concordia College-Selma
admissionstop
Application for Admission
Online Application for Admission
 
By submitting this online application you are attesting to the truth of all items. Upon submission, you will be contacted by a member of the Concordia College Admissions staff.
 
 

INSTRUCTIONS:  Complete or check blocks that apply to you.  All required fields must be completed in order to submit your application. 

 

 

Online Admission Application:

1.
* I am applying as: (1 required)
Beginning Freshman   Transfer
Special (Non-Degree)   Returning Student
2.
*

I am applying for:

 (1 required)
Fall 2012   Spring 2013

STUDENT INFORMATION:
3.
* Last Name, First Name, M.I. (Maiden)
4.
* Home Street Address:
5.
* City, State, County, Zipcode:
6.

International P.O. Box
7.
* Telephone Number:
8.
Email Address:
9.
* Sex:
Female   Male
10.
* Marital Status: (1 required)
Married   Single
Divorced   Separated
11.
* Date of Birth (month/day/year):
12.
Place of Birth:
13.
Religious Denomination:
14.
* Are you a veteran:
No   Yes
15.
* Do you have children?
No   Yes
16.
* Ethnic Background: (1 required)
African American   White/Caucasian
Hispanic   Non-Resident Alien
Other
17.
If Non-Resident Alien, Give Country:
18.
* Name of Graduating High School / Year:
19.
High School Street Address / City / State / Zipcode:
20.
* Rank in high school graduating class: (1 required)
Top 10%   Top 25%
Other
21.
Cumulative Grade Point Average:
22.
List all Colleges or Universities attended (including Concordia College, if applicable):
23.
* Are you academically eligible to re-enter the last college or university you attended?
Yes   No
24.
* Are you socially eligible to re-enter the last college or university you attended?
Yes   No
Your classification at Concordia College:
25.
* Attendance:
Full Time (12 or more credit hours)   Part-Time (Less than 12 credit hours)
26.
* Type of Classes Expected to Enroll in Primarily: (1 required)
Day   Evening
Saturday
27.
* Classification: (1 required)
Freshman   Sophmore
Junior   Senior
Transfer   Transient
Other
28.
* Housing:
On-Campus   Off-Campus
29.
Intended Major / Minor:
30.
* Do you plan to enter Lutheran church work?
Yes   No
31.
* Indicate your enrollment intent at Concordia College: (1 required)
To Earn an Associate of Arts Degree (AA)   To Earn a Bachelor of Science Degree (BS)
To Earn Credits to Transfer Elsewhere   To Earn Certificate Work
I Only Want to Take a Couple of Courses for Self-Improvement   Unsure
32.
* Has anyone in your family attended college?
Yes   No
33.
* If yes, indicate which member(s): (1 required)
Mother   Father
Sister   Brother
N/A
34.
* How did you learn about Concordia College-Selma? (1 required)
High School / College Fair   High School Counselor
High School Presentation   Poster/Radio/TV/Newspaper
College Presentation   Internet
College Guide   Currently Enrolled Student
Other
35.
Name of Recruiter or Person who Recruited You:
Parent/Guardian Information
36.
* Name of Parent or Guardian(s):
37.

Street Address of Parent or Guardian(s):
38.
Parent/Guardian(s) City / State / Zipcode:

IF ADMITTED, I AGREE TO ABIDE BY THE RULES AND REGULATIONS OF CONCORDIA COLLEGE-SELMA.
39.
*

Date of Application:

Type in the text that you see above:

  

 

 

Concordia College Selma       
1712 Broad Street
Selma, AL 36701

Phone: 334-874-5700
Contact Us

 

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