Williams Baptist College

Application For Admission

Admission Status

Date of Entry	Classification	Housing Plans

Personal Information

Last Name/Surname: First Name:

Middle:

Maiden Name: Preferred Name:

Under what other name might we receive information?

Are you a United States Veteran? Yes No

Are you a United States Citizen? Yes No

SS Number (XXX-XX-XXXX):

Male

Female

Date of Birth:

Email Address:

Mailing Address:

City: State: Zip:

County:

Cell Phone: Phone:

How do you prefer to be contacted?
Home Phone Cell Email Mail Facebook
Instant Message:
Screen Name:
Service:

Are you a non-traditional student? Yes No
(A non-traditional student is over 24 years of age, and/or married and/or a custodial parent)

Have you visited Williams? Yes No

Ethnic Background (optional):

Are You Single Married - Spouse's Name:

Family Information (for traditional students only)

Father's Information:	Mother's Information:
Check if address the same	Check if address the same
Name in Full:	Name in Full:
Address:	Address:
City:	City:
State: Zip:	State: Zip:
Phone:	Phone:
Email:	Email:

Title/Occupation:	Title/Occupation:
Employer:	Employer:
College and Degree:	College and Degree:
Attended Williams? Yes No	Attended Williams? Yes No
Who should be contacted in case of any emergency? Name and Phone:
Name of brothers and sisters, their ages and year in school:
Give the full name, relationship, address and daytime phone number of the parent and guardian with whom official correspondence should be sent:

Name: Relationship:

Home Address:

City: State: Zip:

Daytime Phone:

Family members who are attending or have attended Williams? (Give name, relationship, and class year):

Check if: mother is deceased father is deceased
parents are divorced father is remarried mother is remarried

Church Information

Church member? Yes No

If Yes, what denomination?

Church Name: Address:

City: State: Zip:

Are you planning to pursue a church career? Yes No

If yes, what type of ministry?

Academic Information

Name of High School(or GED):

Graduation Date:

City: State: Zip:

Country:

What type of school? G.P.A. on a

ACT Composite SAT: Verbal Math:

Do you plan to retake the ACT or SAT? When?

Are you seeking a degree from Williams Baptist College?

Major:

To which other colleges or universities will you apply?

List any college credits you have already or will be receiving from the high school concurrent credit program (please include the name of the institution and names of courses):

Note: It is your responsibility to have your transcripts forwarded to William's Baptist College.

Transfer Information

Are you presently attending any college or university? Yes: No:

Please list ALL institutions, locations, and dates you have attended. Failure to provide a list of all colleges attended (including correspondence and extension courses) may result in delay of admission, loss of credit, and/or dismissal. It is the applicant's responsibility to have official transcripts forwarded from EACH college attended. An official transcript is required even if attendance was for a brief time and even if no credit was established. Please list in descending order beginning with the current or most recent college or university.

Name of Institution	City and State	Dates Attended	No. of Credits	G.P.A.

Financial Aid Information

Do you plan to apply for financial aid? Yes No

Will you be filing a FAFS? Yes No

If yes, do you wish to apply for the Federal Workstudy Program?
Yes No

Will you receive scholarships from non-Williams Baptist sources?
Yes No

If yes, please list names and amounts:

Extracurricular Information

Briefly describe any School, church, or civil honors that you have received and list any extracurricular activities including sports in which you have participated.

Activity	Grade level or post-secondary (PS)					Role/Honors	Do you plan to participate in college?
	9	10	11	12	PS
							Yes No
							Yes No
							Yes No
							Yes No
							Yes No

Verification

Have you ever been convicted of a crime higher than a traffic violation?
Yes No (If yes, please explain in detail.)

Submission of this form certifies that the information herein is complete and correct and that all attended educational institutions are specified. Falsification of any information on this form could result in dismissal from Williams Baptist College.

Select here to proceed then click SUBMIT below.

Note: Any student who makes application to Williams over the internet will have his/her application fee of $20 waived.