Admission Application for Traditional Students
Personal Information
Application Date:11/20/2009

First Name: Last Name: Middle In:
Street Address: City: State:
ZIP/Postal Code: Country: E-mail:
Date of Birth: Social
Security #:
Home phone: Cell phone: IM screen name:

Sex: Billing Address (If different than above):

Are you a citizen of the United States?: Yes No U.S. Permanent Resident

If you are not a U.S. Citizen-Country of Birth:

I am applying as:
 Freshman
Transfer
Entrance:
 Jan. 2010
Sept. 2010
Jan. 2011
Degree:
 Bachelor
Associate
Housing:
 Resident
Commuter


Academic Areas of Study

Bachelor of Science Degrees:Bachelor of Arts Degrees:
Biology B.A/MOT in Occupational Therapy

Business Liberal Studies

Criminal Justice Legal Studies

Legal Studies Psychology

Forensic ScienceAssociate Degrees:
Biotechnology

I am undecided at this time


Education Information
Freshman:Please list every high school you have attended.
Transfers:Please also note the college in which you are currently enrolled and all others attended.

Name of High School
or College		StateDates of Attendance
Month and Year		Expected date
of graduation

x
Counselor's Name:Counselor's Telephone #:GPA:

SAT I Scores: Math
 List Dates:
Critical Reading
 List Dates:
Writing
 List Dates:
ACT Scores Comp. List Dates:
TOEFL/ELPT Scores: List Dates:

Have either of your parents earned a 4-year Batchelor's Degree? Yes No Don't Know
Have you ever been dismissed from any institution of learning? Yes No
If yes, please explain:


Honors Activities

Please list any co-curricular activities in the past four years. Include specific events and/or major accomplishments, such
as musical instruments played, varsity letters, honors, awards, and prizes you have received.

ActivityNumber of years
of participation		Positions held or
honors won		Continued in college?
Yes No
Yes No
Yes No
Yes No
Yes No


Full- and part-time jobs held

EmployerCity/TelephoneType of WorkStart/End date
of Employment		Hours/Week


Family Information

Father's (or Guardian's) Full Name: Mother's (or Guardian's) Full Name:
Address: Address:
City: City:
State: State:
ZIP/Postal Code: ZIP/Postal Code:
Country: Country:
Telephone: Telephone:
Cell phone: Cell phone:
E-mail: E-mail:
Employer Telephone: Work Telephone:
College Attended College Attended
Degree Earned: Degree Earned:

With whom do you reside? Relationship to applicant:
Name: Address:
May we contact your parents regarding your application? Yes No


Names of Brothers
and Sisters		AgeCollege Attended (if any)Relatives who have
attended Bay Path

How would you describe yourself? (This section is optional.)


Admissions Materials
Alumna
Bay Path Student
Campus Visit
Coach
College Night or Fair		 Counselor
Event
Fair
Friend
Guidebook
Internet		 Open House
Overnight
Parent
Personal Interview
Reputation/Word of Mouth
Teacher

To which other colleges are you applying?
Is Bay Path your first choice? Yes No

Emergency Contact Information:
Name:
Address:
City, State, Zip
Phone Number:
Relationship to Applicant:

REQUIRED SIGNATURE
I certify that all information submitted in the admission process—including the application, personal essay or writing sample, any supplements, and any supporting materials—is my own work, factually true, and honestly presented. I understand that I may be subject to disciplinary action, including admission revocation or expulsion, should the information I’ve certified be false. I authorize all secondary schools and colleges I have attended to release all requested records, including transcripts and standardized test scores, and authorize review of my application for the admission process indicated on this form.

I authorize all secondary schools and colleges I have attended to release all requested records and authorize review of my application for the admission process indicated on this form.

Bay Path College admits students of any race, color, national or ethnic origin, physical limitation, religion, age or sexual orientation to all rights, privileges, programs, and activities generally accorded or made available to students at the college. Bay Path College does not discriminate on the basis of race, color, national or ethnic origin, physical limitation, religion, age or sexual orientation in the administration of its educational policies, admission policies, scholarship and loan programs, and other College-administered programs. The information regarding diversity requested on the application form is for the completion of statistical information only and is not used as a basis for admission or financial aid.

Thank you for applying to Bay Path College.