University of Montevallo - Undergraduate Admissions

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: ___Male   ___Female

Social Security Number: __ __ __ - __ __ - __ __ __ __ Email Address: _________________________

Are you a legal resident of the State of Alabama? ___Yes   ___No

Have you resided, or will you have resided, in Alabama for the twelve months preceding the date of planned
enrollment? ___Yes   ___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?   ___Yes   ___No   (Documentation may be required)

Did either of your parents graduate from a four-year college or university? ___Yes   ___No

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

Predominant Ethnic Background Are you Hispanic or Latino? ____yes ____no Select one or more of the races listed below to indicate which you consider yourself to be.	Non U.S. Citizen: ___ Country of Citizenship: ______________ Permanent Resident ___(green card holder must include copy of green card) Non-Resident Alien ___ Type of Visa: ______________________ Religious Preference:_________________ Undergraduate Classification (check one) ___ Freshman ___ Transfer ___Former UM Student ___ Transient ___Temporary ___High School Student ___Second Bachelors Degree
___American Indian or Alaskan Native
___ Asian
___ Black or African-American
___ Native Hawaiian or other Pacific Islander
___ White
Year you intend to enroll at UM: ______________
Semester of entrance for which you are applying (check one)
___ Fall Semester (August)
___ Spring Semester (January)
___ May term
___First Summer Session (June)
___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? __Yes __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. ___Yes ___No

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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