Application for New Non-Degree Seeking Admission This application is for students interested in taking courses at KU for the first time and do not wish to apply them toward a KU degree. There are restrictions on non-degree seeking students, such as a limited number of credit hours taken per semester and no financial aid award is available. Students that have earned grades at KU after high school (excluding KU Continuing Education courses) must fill out the Undergraduate Application for Readmission. Type or use black ink or you may apply online at www.admissions.ku.edu. Please do not do both. There is a $30 application fee. Application deadlines: Spring 2011 – January 7; Summer 2011 – May 24; Fall 2011 – August 8 1. Applicant Information: (Required) Legal Name: Last First Middle Maiden name or other last names used Preferred First Name (If different than Legal Name) ________ - _____ - __________ Gender: Female Male / / Social Security Number: (required for financial aid and online status check) Birth date: month/day/year ( ) Applicant’s mailing address: Street City and State ZIP code County, if Kansas Home phone: Area code and phone number E-mail address Permanent Home: City/State/Zip/County 3. Race & Ethnic Background: 2. Citizenship: (Required) Yes , I am Hispanic or Latino. Are you a U.S. citizen? (If Yes, please skip to #3,Race & Ethnic Background) yes no If no, are you a permanent U.S. resident? yes no No, I am not Hispanic or Latino If yes, please provide a copy of your card and your alien registration number: ______________ What is your race? If no, will you have non-immigrant status (F-1, J-1, H-4, etc.), while at KU? yes no American Indian or Alaska Native If yes, please fill out the international student application. Contact International Student and Asian Scholar Services at (785) 864-2616. Black or African American Is English your first language? yes no Native Hawaiian or Other Pacific Islander 4. Parent or Guardian Information:(this section is optional for applicants who are 21 or older) White ( ) Name of parent(s) or guardian(s) Relationship Area code and phone number Parent/guardian home address: Street City and State ZIP code Are you the dependent of a yes no E-mail address (optional) KU employee? 5. Kansas Residency Information: (Required) Are you a U.S. military veteran? yes no Are you a resident of the state of Kansas? yes no Are you an active duty member If yes, provide dates for any period you have lived in Kansas / / / / of the U.S. Armed Forces? yes no from M/D/Y to M/D/Y Are you the dependent of an If yes, List your most recent Kansas address active duty member of the yes no U.S. Armed Forces? Last year, did anyone claim you as a dependent for income tax purposes? yes no Do you intend to use the Montgomery GI Bill Education yes no If yes, who? benefits while attending KU? Address City and state ZIP code 6. Enrollment information: (Required) When will you enter KU? Spring 2011 Summer 2011 Fall 2011 Have you ever applied to KU before? yes no If yes, did you earn grades at KU after high school? yes no If yes, STOP - you must fill out the Application for Readmission 7. Educational Information: (Required) High School or GED Name City and State Graduation or GED date Mo/Yr If you plan to take a course at KU that requires a prerequisite (such as math), you must meet that before being allowed to enroll. You must request the official college transcript be sent directly to KU and inform us which courses you will be taking at KU, so that we may post the necessary prerequisite courses. Have the college send the transcript to the University of Kansas Office of Admissions and Scholarships, 1502 Iowa Street, Lawrence, KS 66045-7576. Do you have an undergraduate bachelor’s degree? yes no 8. Program of Study: As a Non Degree Seeking student, you will be placed in the College of Liberal Arts & Sciences. If you are interested in taking a course in one of the University of Kansas Professional Schools (.ie. School of Engineering), please contact the Dean’s Office for the school of your interest for permission. 9. Work Experience: (Required if not in high school) For residency purposes, you must list what you have been doing for the past year. Please list all work experiences during this time. If you were not working, please list what you have been doing (ex: volunteer, travel, stay-at-home parent, etc.) and the dates of each. Attach extra sheets if necessary. Name of employer Location Dates Job title From To City and State Mo./Yr. Mo./Yr. From To City and State Mo./Yr. Mo./Yr. 10. Application Fee:(Required) For admission, send $30 nonrefundable application fee. Send a check, money order, or MasterCard or VISA number (sorry, no other credit cards are accepted using the paper application) payable to The University of Kansas, Office of Admissions and Scholarships, KU Visitor Center, 1502 Iowa, Lawrence, KS, 66045-7576. Do not send cash. Card type: V ISA Mastercard Expiration date __ /__ Card#: __ __ __ __ /__ __ __ __ /__ __ __ __ /__ __ __ __ Name on Credit Card Cardholder’s signature 11. Student Certification and Signature: (Required) I certify that the information provided in this application is true and accurate without evasion or misrepresentation. I understand that this application is a legally binding document and if this information is found to be false or misleading, this fact alone will be sufficient cause for my admission to be denied or revoked and my enrollment to be canceled. Applicant’s signature _____________________________________________________________________ Date:_________________________ This application can be mailed or hand delivered to the Office of Admissions, KU Visitors Center, 1502 Iowa Street, Lawrence, KS 660 This application can not be faxed or emailed.