Alabama's Public Liberal Arts University

Undergraduate Admissions

Printable Application

 

THE UNIVERSITY OF MONTEVALLO
UNDERGRADUATE APPLICATION FOR ADMISSION

Office of Admissions
Palmer Hall, Station 6030
University of Montevallo
Montevallo, AL 35115
Attach or enclose check or money order for $25.00 non-refundable application fee. Fee is waived for former students applying for re-admission.

Complete all three sections, sign and return to the above address.

1. -----------------------------------------------------------------------------------------------------------
Applicant__________________________________________________________________________

                                Last Name/Family Name                                               First Name                                     Middle Name (Initial)
Mailing Address:_____________________________________________________________________

                                                   Number & Street                                                        City / State/ Zip Code
_________________________________  Telephone number:  (______)_________________________ 
                                 County (for Alabama residents)                                                       Area Code and Number                 

Date of Birth:  month/day/year_____________________     Gender:  ٱ Male   ٱ Female
 
Social Security Number: __ __ __ - __ __ - __ __ __ __ Email Address: _________________________
 
Are you a legal resident of the State of Alabama?  ٱ Yes   ٱ No

Have you resided, or will you have resided, in Alabama for the twelve months preceding the date of planned
enrollment?  ٱ Yes   ٱ No  (Documentation may be required)

Have your parent(s) resided, or will they have resided, in Alabama for the twelve months preceding the date of planned enrollment?   ٱ Yes   ٱ No   (Documentation may be required)

2. -----------------------------------------------------------------------------------------------------------

Predominant Ethnic Background (used only for required
government reports)
Non U.S. Citizen:  ٱ
Country of Citizenship: ______________
Permanent Resident ٱ
 (green card holder
          must include copy of green card)

Non-Resident Alien
   ٱ
Type of Visa: ______________________ 
Religious Preference:_________________

Undergraduate Classification (check one)
ٱ
  Freshman
ٱ
  Transfer
ٱ
 Former UM Student
ٱ  Transient
ٱ  Temporary
ٱ  High School Student
ٱ  Second Bachelors Degree
ٱ  American Indian or Alaskan Native
ٱ  Asian or Pacific Islander
ٱ  Black Non-Hispanic
ٱ  Hispanic  
ٱ  White non-Hispanic
Year you intend to enroll at UM: ______________
Semester of entrance for which you are applying (check one)
ٱ  Fall Semester
ٱ  Spring Semester
ٱ  May term
ٱ  First Summer Session   (June)
ٱ  Second Summer Session  (July)

Intended Major: __________________ Intended Minor: ___________________Undeclared: __________
                          (Follow this link for a list of academic programs
)
3. -----------------------------------------------------------------------------------------------------------

List Last High School and all Colleges Attended Dates Diploma/Degree
High School      
Colleges      
       
     
     
     

Other names under which transcripts may be listed:____________________________________________
Previously applied to or attended Montevallo? 
ٱ Yes  ٱ No    If "Yes" indicate year(s): ______________

I certify that I comply with the provisions of the United States Military Selective Service Act (50 U.S.C.
App. 543) by having registered with the Selective Service Board or that I am not yet 18 years of age and
I will register when required or that I am not required by law to register.

The information herein is complete and accurate.  I understand that incomplete and inaccurate
application information may result in my being ineligible for admission and enrollment.

Signature: ________________________________________________________Date: _____________
 

The University of Montevallo is an equal opportunity educational institution and does not discriminate on the basis of age, color, creed, handicap, national origin,
 race, religion or sex.

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