The Campolo
College of Graduate and Professional Studies


Undergraduate Programs
Please indicate  program of  choice: (check one only)

Associate of Arts in Liberal Arts
Associates in Liberal Arts with an Early Childhood Education Concentration
Bachelor of Arts in Criminal Justice
Bachelor of Arts in Youth Ministry Leadership
Bachelor of Science in Early Childhood Education
Bachelor of Arts in Organizational Leadership (ORG)
Bachelor of Science in Business Administration (DBUS)
Bachelor of Science in Nursing for Registered Nurses (RN-BSN)
Bachelor of Science in Nursing-Second-degree Nursing Program (BSN Two2)
General Studies Courses
General Studies Courses (Visiting Student Only)

 

PERSONAL INFORMATION

 FULL NAME:                             
 

(Last)

(First)

(Middle Initial)
 
 
 
If your name will appear in any other form on transcripts or documents, enter name(s) here (maiden, married, family name, etc.):
MAILING ADDRESS:
CITY:
STATE:
ZIP:
HOME PHONE:
WORK PHONE:
CELL PHONE:
FAX NUMBER:
E-MAIL:
DATE OF BIRTH:

Month

Date

Year

   
SS#:
 

xxx-xx-xxxx
     START DATE:  
   

Month
 

Date
 

    Year
 

 
PREFERRED: LOCATION
(for AA Liberal Studies Only)
   
PREFERRED: LOCATION
(for Business Administration Only)
   
PREFERRED: LOCATION
(for Org. Leadership Only)
How did you hear about Eastern University?
PREFERRED: LOCATION
(for RN-BSN Only)
PREFERRED: LOCATION
(for BSN Two2 only)
PREFERRED: LOCATION
(for BS/ECE(ACED) only)


 

OPTIONAL FOR INSTITUTIONAL RESEARCH PURPOSES ONLY:


Choosing an ethnicity/race
 
(Click on the link to see separate page with explanation)
 

HISPANIC/LATINO Yes                 No RACE (Please choose one or more options below)
    American Indian or Alaska Native
RELIGIOUS AFFILIATION: Asian
GENDER: Male   Female Black or African American
    Native Hawaiian or other Pacific Islander
    White
 

Are you interested in applying for financial aid? (not eligible for visting students)    Yes    No

CITIZENSHIP INFORMATION
ARE YOU A U.S. CITIZEN? Yes    No  
COUNTRY OF CITIZENSHIP:  
COUNTRY OF BIRTH:  
If CURRENTLY IN THE U.S.   
ARE YOU A PERMANENT RESIDENT OF THE US ?      Yes    No IF YES, WRITE THE Alien Resident #  A  IN THE BLANK PROVIDED.   
IF NO, WHAT IS YOUR CURRENT VISA STATUS? (ie, F-1, H1-B) SEVIS NUMBER
PLEASE SEND TO THE ADMISSIONS OFFICE LEGIBLE PHOTOCOPIES OF YOUR CURRENT IMMIGRATION DOCUMENTS, SUCH AS GREEN CARD, PASSPORT, VISA, I-94, I-20, ET. AL.THESE DOCUMENTS ARE NECESSARY BEFORE YOUR FILE WILL BE REVIEWED.

FOREIGN RESIDENCE ADDRESS (IF DIFFERENT FROM MAILING ADDRESS)

EDUCATION INFORMATION


(Please check one)
  HIGH SCHOOL GRADUATE      YEAR OF COMPLETION:    
  GED CERTIFICATE       YEAR ISSUED:    
HIGH SCHOOL NAME:        
CITY:  STATE:    PHONE:      

 

List all postsecondary colleges, universities, graduate and professional schools you have attended for credit. (Include Eastern if you previously attended.) Also, if applicable, list branch of military service, college credit tests taken (CLEP, PEP, DANTES, USAFI) and certificates and/or licenses earned.

INSTITUTION NAME


 DATES ATTENDED

TOTAL HOURS/CREDITS
    FROM     TO 
    FROM     TO 
   FROM     TO 
   FROM     TO  
   FROM     TO  

RN-BSN Applicants only: Please provide a copy of your current RN licensure.
 

EMPLOYMENT INFORMATION




ARE YOU
CURRENTLY EMPLOYED:
Yes  No FULL TIME   PART TIME     

EMPLOYER'S NAME:

PHONE:
EMPLOYER'S ADDRESS:  
CITY:               STATE:  ZIP:
JOB TITLE:
 
WILL YOUR EMPLOYER PROVIDE TUITION REIMBURSEMENT?   Yes   No IF YES, WHAT PERCENTAGE?
 

ADDITIONAL INFORMATION



HAVE YOU EVER BEEN CONVICTED OF A CRIME IN UNITED STATES OR ANY OTHER COUNTRY Yes  No

IF YES PLEASE EXPLAIN:


PLEASE PROVIDE FOR US THE NAMES AND CONTACTS FOR TWO RECOMMENDATIONS. RECOMMENDATIONS WILL ONLY BE CONTACTED IF NECESSARY
REFERENCE NAME:  
PHONE NUMBER :               EMAIL ADDRESS:
REFERENCE 2 NAME:  
PHONE NUMBER :               EMAIL ADDRESS:
 

CREDIT REQUIREMENT DISCLOSURE

IF YOU ARE SEEKING AN ASSOCIATE'S DEGREE, YOU WILL NEED A TOTAL OF 61 CREDITS TO BE ELIGIBLE FOR GRADUATION.

IF YOU ARE SEEKING TO EARN A BACHELOR DEGREE, YOU WILL NEED TO COMPLETE YOUR MAJOR AND CORE REQUIREMENT AREAS AND A MINIMUM OF 121 CREDITS TO BE ELIGIBLE FOR GRADUATION.

ALL STUDENTS MUST COMPLETE THEIR FINAL 32 CREDITS AT EASTERN UNIVERSITY IN ACCORDANCE WITH UNIVERSITY POLICY.

PLEASE READ AND SIGN

I HAVE READ AND UNDERSTAND THE DEGREE REQUIREMENTS DISCLOSURE THAT EXPLAINS THE NECESSARY CREDIT REQUIREMENTS FOR GRADUATION.

I UNDERSTAND THAT I AM RESPONSIBLE FOR SUBMISSION AND RECEIPT, BY THE UNIVERSITY, OF OFFICIAL TRANSCRIPTS OF MY RECORDS, AND THAT THE UNIVERSITY  WILL  ACCEPT, AS ITS OWN PROPERTY AND FOR ITS PERMANENT FILE, ONLY THOSE OFFICIAL TRANSCRIPTS ISSUED DIRECTLY BY EACH INSTITUTION I HAVE ATTENDED.

I UNDERSTAND IT IS MY RESPONSIBILITY AS AN APPLICANT TO MONITOR THE STATUS OF MY APPLICATION AND ENSURE THE COMPLETION OF MY ADMISSIONS FILE.

FORMAL ADMISSION TO EASTERN UNIVERSITY AS A DEGREE CANDIDATE IS GRANTED ONLY AFTER ALL ADMISSION MATERIALS HAVE BEEN RECEIVED, ALL ADMISSION REQUIREMENTS ARE MET.

I CERTIFY THAT THE INFORMATION GIVEN ON THIS APPLICATION FOR ADMISSION IS COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE, AND I HAVE ATTENDED NO COLLEGES AND/Or INSTITUTIONS OTHER THAN THOSE LISTED. I ALSO AUTHORIZE EASTERN UNIVERSITY TO MAKE APPROPRIATE INQUIRIES WHEN NECESSARY TO VERIFY THE ACCURACY OF MY RECORDS.
 

SIGNATURE:   DATE:

 

Please note that by clicking on “submit” above you are giving Eastern University permission to contact you via email. You can ask to be removed from our contact list at any time.

Please mail $25.00 non-refundable application fee, and have all official transcripts
 and recommendations forwarded to:

Eastern University
The Campolo College of Graduate and Professional Studies
Department of Admissions
1300 Eagle Road
St. Davids, PA 19087-3696
ccgps@eastern.edu

 

Eastern University is accredited by the Middle States Commission on Higher Education (MSCHE).

Eastern University is committed to providing Equal Educational and Employment Opportunity to all qualified persons regardless of their economic or social status and does not discriminate in any of its policies, programs, or activities on the basis of gender, race, handicap, marital or parental status, color, or national or ethnic origin.

Per the "Electronic Signature in Global and National Commerce Act of January 2000", Eastern University accepts the above electronic signature as valid and legal.