Early Enrollment and Dual Credit Application

Citizenship and Address Information

Street:

Apt, Suite (Optional)

City

Country/Region:

State:

State/Province/Region:

Zip/Postal Code:

Citizenship

Are you a U.S. permanent resident?

YesNo

Is there a language other than English spoken in your home?

If you chose Other, please specify:

For U.S. citizens or permanent residents, please provide your social security number:

Please note, when inputting your Social Security Number we take measures to protect your information. Your information is encrypted and will not be shared with anyone.

Enrollment Details

What type of student will you be?

Dual Credit - Highschool student enrolling in a course at their High School
Early Enrollment- Highschool student enrolling in a course on the Goshen College campus

Anticipated Start Term

Anticipated Start Term ID

Anticipated Start Term Date

Please choose the area of study that currently interests you

Anticipated Major ID

Current High School Name:

School ID:

Current Year in High School

Graduation/Expected Graduation date (if none, leave blank):

GPA/Expected GPA

GPA Scale

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name:

Parent/Guardian Email:

Please make sure you enter a valid email address that includes '@' and '.com' otherwise, your application will not be submitted.

Parent/Guardian Phone Number:

Relationship to you:

Do they live at the same address as you provided on this application?

Please provide their address below:

Parent/Guardian Street:

Parent/Guardian Apt, Suite (Optional)

Parent/Guardian City:

Parent/Guardian Country/Region:

Parent/Guardian State:

Parent/Guardian State/Province/Region

Parent/Guardian Zip/Postal Code:

Did either of your parents attend Goshen College?

Have any of your siblings or grandparents attended Goshen College?

Please select all that apply:

GrandparentsSiblings

Final Statements

Goshen College reserves the right to select students on the basis of academic performance and personal qualifications. Goshen College is in compliance with all applicable federal regulations pertaining to nondiscrimination on the basis of race, color, national or ethnic origin, sex, disability, age, sexual orientation, gender identity or any legally protected status in its recruitment, admission, educational, athletic, financial aid and employment policies and programs.

Have you ever been accused of or convicted of a felony?

If yes, please email an explanation to the Director of Admission at: director.admissions@goshen.edu

Goshen College is dedicated to fostering a spirit of hospitality on our campus, including all students, faculty and staff and college guests, as part of maintaining a healthy living and learning community. In order for a diverse community to thrive, we must recognize our differences and seek understanding and integrity in our relationships. Students and faculty at Goshen College are expected to support an environment of mutual respect and accountability, to care for the personal dignity of others and to have integrity in their conduct and communication. Alcohol and illegal drug use or possession on campus is strictly prohibited. All forms of tobacco use are also prohibited on campus.

By typing my full name below I affirm and verify the accuracy of the information given in this application, and I understand that this affirmation is a legally binding equivalent of my written signature and indicates awareness of and agreement to live in harmony with Goshen College's Community Standards.

Your Name:

Date:

Review and Submit

You're almost done! Please take a moment to go back and review your answers before hitting submit. Once you hit submit you will be unable to edit your answers.