CAS Residential Learning Community
APPLICATION FORM
Applications will be prioritized by date received.
PERSONAL INFORMATION
Bolded fields are required.
Last Name :
First Name :
Middle Name :
Male/Female :
Address :
City :
State :
Zip :
Area Code & Telephone Number :
Student Email Address :
(your KSU email)
Banner Student ID# :
(if available)
Current High School :
Do you need any special living accommodations or facilities? :
If yes, please explain :
The CAS Residential Learning Community rooms are double occupancy in Wright Hall. This is a coed hall with male and female students living in the building but on separate floors. If you have a roommate preference, indicate that person's name.
Note: Your roommate must be willing to move into Wright Hall and be accepted for participation in the CASRLC.
Name of Roommate Preference :
College of Arts and Sciences Major :
Check all appropriate Racial/Ethnic identifications that apply to the applicant :
If you wish, please provide additional information about your racial/ethnic identification :
List your major field(s) of interest upon starting college :
Have you taken college courses while in high school? If yes, how many hours and at what institution? :
What is your current cumulative high school GPA? :
What were your scores on the ACT? :
SAT? :
Please answer the following questions in short essay format (no more than 2 paragraphs per questions).
Why do you feel you should be chosen to become a member of the CAS Residential Learning Community? :
Why are you interested in pursuing a career in the College of Arts and Sciences? :
What is your main concern as you begin your college career? :
By typing my name below I signify that the above information is correct.
*June 15, 2013 is the deadline to apply*
Signature :
Date :
mm/dd/yy
