* - Indicate required fields

1. Applicant's Name:

   *Last Name
   * First Name
   Middle Name

   
   
   Please list maiden name under which any former transcripts may be listed:
   
   
2. Social Security Number :
   

   				- -
   * Email

   
   
   
3. Mailing Address (include number, street and apartment number):
   

   Street
   City /Town	State	Zip Code
   Country (if not US)

   
   
   
4. Citizenship: Select One US Citizen Non-US Citizen Permanent Resident   Country Of Citizenship
   
   
   
5. * Date of Birth (month/day/year): Month Select One January February March April May June July August September October November December Day Select One 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year(yyyy)
   
   
   
6. Telephone Numbers (include area codes): Home Work
   
   
   
7. The following question is optional and will not be used in consideration
   of your application for admission. Please describe yourself: Select One Asian/Pacific Islander Hispanic African American White/Caucasian Multi-Racial Other
   
   Other
   
   
   
8. *Location:

   Riverdale Campus (all majors)

   St. Vincent's Midtown Hospital, NYC (transfer nursing majors only/commuters only)

   
   
   
9. Year of Desired Entrance:

   2008 2009 2010 Fall Semester (August) Spring Semester (January) male female freshman transfer
   resident (Live on Campus) commuter (Live off Campus) * Select One full time part time

   
   
   
10. Check if you wish to be considered for:
    Early Action (Application deadline is Nov. 1 with notification by Dec 1.  Early Action acceptance is non binding.Candidates who are admitted under this program will have untill May 1, 2008 to submit their enrollment deposit.)
    Financial Aid (You must submit the FAFSA to the U.S. Dept of Education and the TAP Application if you are a resident of the state of New York)
    
    
    
11. Have you previously applied for admission to the College of Mount Saint Vincent? Yes No
    If yes, enter Year: 
    
    
    
    
12. Have you ever been charged with a felony? Yes No
    If yes, Please Explain: 
    
    
    
    
13. Major/Area of Interest:
    Please indicate your tentative choice of major at Mount Saint Vincent. YOUR CHOICE IS NOT BINDING. 
    If you are unsure of your choice, select "Undecided."
    A. Please check intended field of study.
    
    

    Biochemistry	Biology	Business          Accounting          Human Resources Management          Management of Organizations          Marketing          Finance          Business Economics          International Business	Chemistry
    Communications          Broadcasting          Cinema Studies          Corporate          -Communications          Journalism	Economics	English         Creative Writing	French
    History	Liberal Arts	Mathematics	Nursing
    Philosophy	Psychology         Biological         Clinical         Cognitive         Developmental         Social	Sociology         Criminology         and Justice Social         Work	Religious Studies
    Spanish	Undecided

    
    B. Teacher Education:
    

    Elementary

    Secondary

    Special Education

    Dual Certification         Regular/Special Education

    
    C. Indicate, if appropriate:
    

    Pre-Dental	Pre-Law	Pre-Medical	Pre-Physical Therapy
    Pre-Occupational Therapy	Pre-Optometry

    Minor:
    

    Fine Arts

    Writing

    Political Science

    
    
    
14. Academic Information:

    Name Street  City    State Attended from Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / (year)  to Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / (year)

    Name Street  City    State Attended from Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / (year) to Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / (year)

    High school  (list most recent High School(s) attended first) High School from which you will graduate/have graduated: Graduation Date  (mm/dd/yyyy) Please list Month and Year in which you took/will take the following tests: High School CEEB Code Number (6-number code)

    SAT	TOFEL	ACT
    SAT	TOFEL	ACT

    
    

    Name and contact information of your current or most recent guidance counselor/advisor:
    Full Name
    Email Address
    Guidance Office Phone Number

    Have you taken, or are you now taking any Advanced Placement or other college-level courses? Yes No If you answered "yes" above, please forward an official copy of any applicable test results or college transcripts to the Admissions Office as soon as they are available. The Office of Academic Advisement will notify you, prior to registration, of any advanced standing/credit you may be granted.

15. For Transfer Applicants Only:
    List all colleges or universities you have attended or now are now attending:

    Institute	City	State	From (mm/yyyy)	To(mm/yyyy)	Credits Completed	Degree Received/ Diploma Expected

    
    Cumulative Grade Point Average  Current Major
    
    Nursing Transfers: Are you now, or will you be a Registered Nurse prior to enrolling at Mount Saint Vincent? 
    Check if Yes
    Please list any credit transfer information:
    
    
    
16. Personal Information: (not required for applicants 24 years of age or older)
    
    For High School applicants/transfer applicants with fewer than 24 college
    * Please fill out thoroughly. It may be used when considering applicants for Scholarships/Grants. You may submit a separate if necessary. Be sure the email includes your full name and high school. Please list your primary extra-curricular school and community activities in order of their interest to you. (To select more than one grade level, hold down the control key while selecting each choice.)
    
    

    Activity	9	10	11	12	Position held/ Honors won

    
    Please list any athletic activities in which you participated, indicating intramural, junior varsity, or varsity.
    (To select more than one grade level, hold down the control key while selecting each choice.)
    
    

    Sports	9	10	11	12	Position held/ Honors won

    
    

    Essay: It is required that you submit in a separate email attachment, an essay or statement on the topic of your choice.Submit your essay to admissions.office@mountsaintvincent.edu. Please include your full name and high school/college attended
    Parent/Guardian: (Check here if Parent/Guardian address is the same as student address.)

    
    Father or Guardian:
    
    

    Last Name	First Name
    Middle Name
    Mailing Address (include number, street and apartment number):
    Street
    City/Town
    State	Zip
    Country (if not US)
    Occupation	Employer
    College Attended	Year Graduated College

    
    
    Mother or Guardian:
    
    

    Last Name	First Name
    Middle Name
    Mailing Address (include number, street and apartment number):
    Street
    City/Town
    State	Zip
    Country (if not US)
    Occupation	Employer
    College Attended	Year Graduated College
    To whom should correspondence be sent?	Mother Father Both Guardian Applicant Only

    
    
    Brothers and sisters living at home.
    (Include those currently living away at college.)
    
    

    Name	Age	School now attending	Grade Level

    
    
    Please indicate if any of the following apply to you.
    (for scholarship purposes only)

    Neice/nephew of a Sister of Charity

    Son/daughter of an Alumnus/a

    Filipino Heritage

    ---

    
    
    For All Applicants
    
    I certify that all information contained in this application is true and complete.
    
    Full Name (filling in this box is considered the same as a signature): Date (mm/dd/yyyy):
    
    The College of Mount Saint Vincent does not discriminate against any applicant for admission to the College
    because of race, sex, color, alien, age, citizenship, religion, sexual orientation, disability or marital status. Admission to the College of Mount Saint Vincent is based solely upon the applicant's qualifications and ability to meet educational requirements.
    If you have finished your application press SUBMIT. You will receive a confirmation email.