OCU:PLUS - Application

Social Security Number: Have you ever attended OCU/PLUS? Yes No Year:

Last Name: First Name: Middle Name:

First Name Preference: Other name(s) by which you have been known:

Home Mailing Address

Address:

City: State: Zip:

Country: Citizenship:

Home Phone: Work Phone: Email:

Employer: Position:

Is Employee Tuition Assistance Available? Yes No

Contact Person: Phone:

Have you ever been convicted of a felony? Yes No

Provide Details:

Emergency Contact Information

Name: Relation: Spouse Parent Other Phone:

Address: Alt. Phone:

Voluntary Information

This information is voluntary and will be used in a non-discriminatory manner, consistent with applicable civil rights laws.

Church Affiliation: Sex: Male Female Date of Birth:

Ethnic Background: Black/African-American Hispanic/Latin American Asian-American or Pacific Islander White/Caucasian	Marital Status:
American Indian/Alaskan Native
Other	Other:

Applicant: Indicate your degree preference:
Area of Concentration:

Beginning Semester:

Which of the following most influenced your decision to apply to the Oklahoma City University PLUS Program?

College Advisor/Professor	Who/Where?
U.S. News and World Report Internet Newspaper, Radio, Television
Employer
OCU Graduate Student/Alumni	Name:
Visit to Campus
Other

PLUS Adult Degree Program General Admissions Policy

Admissions to attend Oklahoma City University is considered to be a privilege rather than a right. The university does not discriminate against any individual because of age, sex, race, marital status, physical disability, sexual orientation, or religious affiliation.

The Prior Learning + University Studies program is interested in adult students who want to learn. Careful consideration is given to each applicant. Important factors to be considered are individual motivation, previous grades on college transcripts, prior experiential learning, and the interest and goals of the applicant in relation to the program of study offered by the PLUS program. The university reserves the right to deny admission and to require the withdrawal of any student at any time for any reason as judged by the appropriate university committee.

The Office of Admissions reserves the right to request any additional information before a decision of admission is made. Providing false or incomplete information on this application for admissions may result in a denial of admission or a cancellation of registration.

Academic Experience

List in order of attendance, all colleges or universities you have attended, including graduate and professional schools. Also include the name of the sources of any other credits that may be applied to your degree plan (Military, Dale Carnigie, ACE, CPS, CLEP testing, etc.)

Have you ever served in the armed forces? Yes No

Institution

Location

Attendance (month / year)

Full Name

City, State

Beginning

Ending

Acknowledgement

Oklahoma City University recognizes its responsibilities as an educational institution to promote a productive student environment. This responsibility demands implementation of programs and services which facilitate that effort.

Federal law requires the establishment of anti-drug and alcohol programs that prohibit the use of illegal drugs and alcohol in or on university owned or operated facilities. In order to meet these responsibilities and federal requirements, the university has established this Student Drug and Alcohol Abuse Policy, which is included in the Student Handbook.

I understand that Oklahoma City University has a Student Drug and Alcohol Abuse Policy. I further understand that the vice president for student services is authorized to require those students whom he has reasonable grounds to believe are improperly using or possessing controlled substances in violation of the university's drug abuse policy to participate in the drug screening program.

Oklahoma City University provides equality of opportunity in higher education for all persons, including faculty and employees, with respect to hiring, continuation, promotion, and tenure, applicants for admission, enrolled students, and graduates, without discrimination or segregation on the ground of race, religion, national origin, sex, age, handicap, or disability, sexual orientation, or veteran status.

The vice president for administration and finance, located in Room 402 of the Clara E. Jones Administration Building, telephone (405) 208-5029, coordinates the university's compliance with titles VI and VII of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, the Rehabilitation Act of 1973, the Americans with Disabilities Act, and the Age Discrimination in Employment Act.

I hereby certify that all information provided in this application is true and accurate.

Signature: