TEST_APPLICATION

	Application for Admission and Scholarship Trine University 1 University Avenue Angola, IN 46703-1764

Phone (260) 665-4132 FAX (260) 665-4578 E-mail admit@trine.edu

All items preceded with an * must be completed before submitting your application.

Personal Information
*Last Name
*First Name
*Middle Initial
*Preferred Name
*Permanent Mailing Address
*City
*State
*Zip Code
*County
Effective Until Date
E-mail address
*Home Phone (###)###-####
Additional Address-Select
Additional Mailing Address
City
State
Zip Code
*Date of Birth
*Gender	Female Male
*Social Security Number (###-##-####)
*Marital Status
Maiden Name
*Citizenship
Racial/Ethnic Background (optional)
Academic Plans
*I plan to enter Trine University beginning
*I plan to major in
Sports Interest
Do you plan to play on an athletic Team? Yes No
Please check the appropriate team(s):
Baseball	Men's Swimming
Men's Basketball	Women's Swimming
Women's Basketball	Men's Tennis
Men's Cross Country	Women's Tennis
Women's Cross Country	Men's Track
Football	Women's Track
Men's Golf	Men's Indoor Track
Women's Golf	Women's Indoor Track
Men's Soccer	Men's Volleyball
Women's Soccer	Women's Volleyball
Softball
Educational Background
*High School Graduation Date (month and year)
*Guidance counselor name
*High School Name
*High School City
*High School State

*Are you a transfer student? Yes No
If yes, list all colleges you have attended
Name and address of college attended
Name and address of college attended
Name and address of college attended
General Information
*Do you intend to file the Free Application for Federal Student Aid (FAFSA)? Yes No
*Do you plan to live in University Housing? Yes No
What interested you in Trine University?
Family Information
*Parent/Guardian Name
*Parent/Guardian Address
*Parent/Guardian City, State, Zip
*Parent/Guardian Employer
Parent/Guardian Name
Parent/Guardian Address
Parent/Guardian City, State, Zip
Parent/Guardian Employer
*I reside with
Spouse's Name
Spouse's Address
Spouse's City, State, Zip Code
Spouse's Employer
Have members of your family attended Trine University? Yes No If yes, please enter the name(s) and their relationship to you below.
Name
Relationship
Name
Relationship

I certify that the information provided is true and correct and give my permission to the Scholarship Selection Committee to review and verify this information. I further agree to release information about myself and my academic record at Trine University to organizations or individuals who provide scholarship assistance for my attendance. I understand that I may be obligated to correspond with scholarship donors. If I should fail to abide by this criteria, I will forfeit the award.

I authorize the office of financial aid to release award information as needed to persons or organizations considering me for financial assistance. This may include admission staff, coaches and faculty members who are recruiting or trying to assist me.