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Application Date *

Legal Name: *

First

Middle

Last

Birth Name (if different)

First

Last

Preferred Name: *

First

Last

Mailing Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Mobile #: *

Social Security Number:

If you wish, you may wait until you speak with Dr. Doris Bullock before providing your SS #

Start Term: 23FAL1 (Fall 2023) Catalog: 2023 Intend Load: Full Time

Academic Level: Undergraduate Student Type: In-State

Campus Site: Adult & Online Education (AOE) Raleigh

Financial Aid Intent? *

Program (select one): *

Behavioral Science (Associate of Science)
General Education (Associate of Arts)

Have you earned the High School or High School Equivalency Diploma (select one): *

High School Diploma
High School Equivalency Diploma

Date of HS/HSE Diploma Completion: *

Name of HS/HSE: *

Location of HS/HSE (City, State): *

HS/HSE Phone Number: *

Do you have any prior college experience? *

If you answered YES, please provide the name(s) of the college/university, location (city/state) and dates of any prior colleges/universities attended:

Essay Questions

Please answer the following questions as fully as you can, so we understand your motivation for applying to this program.

Note: Please provide a minimum of 150 words. Without at least 150 words for each essay response (1-3), your application will not be considered.

1. Why are you interested in furthering your education through this partnership program? *

Please provide a minimum of 150 words. Without at least 150 words for each essay response (1-3), your application will not be considered.

Example Answer for Question 1:

2. What are your educational and career goals upon completion of the associate degree? *

Please provide a minimum of 150 words. Without at least 150 words for each essay response (1-3), your application will not be considered.

Example Answer for Question 2:

3. If you could choose one person in your life who has positively influenced you to further your education, who would that person be and why did you choose them? *

Please provide a minimum of 150 words. Without at least 150 words for each essay response (1-3), your application will not be considered.

Example Answer for Question 3:

Essay Questions

Please answer the following questions as fully as you can, so we understand your motivation for applying to this program.

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