Phone: (405) 744-5358 Fax: (405) 744-7092 Email: admissions@okstate.edu Web: admissions.okstate.edu

Office ofUndergraduate Admissions

CONTACT INFORMATIONOffice of Undergraduate Admissions 219 Student Union Stillwater, OK 74078

Oklahoma State University in compliance with Title VI and VII of the Civil Rights Act of 1964, Executive Order 11246 as amended, Title IX of the Education Amendments of 1972, Americans with Disabilities Act of 1990, and other federal laws and regulations, does not discriminate on the basis of race, color, national origin, sex, age, religion, disability, or status as a veteran in any of its policies, practices or procedures. This includes but is not limited to admissions, employment, financial aid, and educational services. Title IX of the Education Amendments and Oklahoma State University policy prohibit discrimination in the provision of services of benefits offered by the University based on gender. Any person (student, faculty or staff) who believes that discriminatory practices have been engaged in based upon gender may discuss their concerns and file informal or formal complaints of possible violations of Title IX with the OSU Title IX Coordinato, Director of Affirmative Action, 408 Whitehurst, Oklahoma State University, Stillwater, OK 74078, (405)744-5371 or (405)744-5576(fax). This publication, issued by Oklahoma State University as authorized by the Office of Admis-sions, was printed by Oklahoma Career Tech Printing at a total cost of $295 500, Nov/14 #4353

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C U R R I C U L A R R E Q U I R E M E N T S * (15 Units)

4 English – Grammar, Composition and Literature

3 Mathematics – Algebra I, Algebra II, Geometry, Trigonometry, Math Analysis, Calculus or AP Statistics

3 History & Citizenship Skills – One unit of American History, plus two units from History, Economics, Geography, Government, Civics and/or Non-Western Culture

3 Lab Science – Biology, Chemistry, Physics or any Lab Science certified by the school district

2 Other – Additional units of subjects previously listed or selected from Computer Science or Foreign Language

TO APPLY AS A CONCURRENT STUDENT, YOU MUST:1. Take the ACT or SAT.

2. Meet at least one of the concurrent admission requirements below.

3. Be eligible to complete requirements for graduation from high school (including curricular requirements* for college admission) no later than the spring semester of your senior year.

C O N C U R R E N T A D M I S S I O N R E Q U I R E M E N T S

24 ACT/1090 SAT or better

3.0 GPA or better unweighted cumulative

ANDTop 33.3% rank in high school graduating class

3.5 GPA or better unweighted cumulative

25 ACT/1130 SAT or better

OR OR

S E N I O R J U N I O R

ACT and SAT scores are computed without including the writing section score.

Home Study or Unaccredited High School: Seniors (17 years of age): 24 ACT or 1090 SAT — Juniors (16 years of age): 25 ACT or 1130 SATGrade-point average and class rank are not used to evaluate students who fall under either Home Study or Unaccredited High School category.

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Oklahoma State University Concurrent Application

Entry Term

1. Entry Term: o Fall 20 o Spring 20 o Summer 20

Applicant Information

2. Legal Name:

Last Name First Name Middle Name Suffix

4. Other Names Used (if applicable):

3. Social Security Number: 4. Date of Birth:

5. Mailing Address:

Number & Street City State/Country Zip Code

5a. I have lived at this address from

6. Email:

7. Home Phone: 7a. Cell Phone:

8. Parents/Guardian Name:

Last Name First Name Middle Name Suffix

8. Parents/Gardian Name:

Last Name First Name Middle Name Suffix

9. Birth Place: _______________________________________________________________________________________________________

City County (if Oklahoma) State Country

10. Is English your native language? o Yes o No 10a. If no, native language:

Applicant Information Responding to this inquiry is voluntary and will not be used in a discriminatory fashion.

11. Gender: o Female o Male 11a. Marital Status: o Married o Single

12. Ethnicity: Please mark only one: 12a. Please mark one or more:

o Hispanic/Latino o Alaskan Native/American Indian*

o Not Hispanic/Latino o Asian

o Black/African American

o Native Hawaiian/Pacific Islander

o White

13. *Tribal Affiliation: _________________________________ 13a. Derived from: o Mother o Father o Both

Residency Status

14. Are you a U.S. Citizen? o Yes o No 15. Are you an Oklahoma resident? o Yes o No

15a. If yes, how many years have you resided in Oklahoma? 15b. If no, list state of residence:

16. Please check box if you are an Undocumented Resident: o If you are an undocumented resident, please mail your Affidavit of Intent to:

Office of Undergraduate Admissions, 219 Student Union, Stillwater, OK 74078

An Affidavit of Intent my be downloaded at http://okla.st/osuaffidavitofintent

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IMPORTANT – Please ensure that the email address provided here is a private and reliable address to which you, the applicant, will have access during the admissions process. OSU communicates essential application and admissions information to this email account.

Non-U.S. Citizens ONLY

17. Country of Birth: 18. Country of Citizenship:

19. Non-Immigrants: Are you the dependent of a parent/guardian living in the U.S. on a visa? o Yes o No

19a. If yes, what type of visa does your parent/guardian have? o F1 o J1 o Other (specify)

20. Immigrants: o Permanent Resident (select one) o Applicant o Granted o Other

21. Have you taken the TOEFL? o Yes o No

High School/Secondary Information

22. Name of Current High School:

23. School Address:

Number and Street City State Country Zip

24. Attended From: To:

25. When is your expected date of high school graduation?

26. If outside the U.S., please list diploma certificate:

27. Have you previously applied to or attended OSU? o Yes o No 27a. If yes, when?

28. Have you earned college credit? o Yes o No 28a. If yes, when?

29. Are you enrolled at another college or university? o Yes o No

If yes, where? Number of credit hours earned for current semester:

30. Have you ever been convicted of a felony? o Yes o No

30a. If yes, please write a description of the circumstances and attach it to this application.

31. Have you ever been suspended or expelled from any college or as a result of of a non-academic issue?

o Yes o No

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Application Checklist — PLEASE SUBMIT A NEW CONCURRENT APPLICATION FORM EACH SEMESTER

o Obtain all required signatures and complete concurrent application.o Attach high school transcript and ACT/SAT scores. (Not required for continuing enrollment)o Submit non-refundable $40 application fee or fee waiver documentation. Concurrent students must submit fee/waiver with

initial application only. An application fee is not required for continuing Oklahoma State University enrollment. For payment options, please visit admissions.okstate.edu/apply/appfee.

o Submit all documents at least 48 hours before you plan to enroll to allow time to process your application. o Print out of proposed high school schedule. Return completed application, including all fees to:

Oklahoma State University Office of Undergraduate Admissions

219 Student Union Stillwater, OK 74078

For questions, please call: (405) 744-5358

THE BACK OF THIS PAGE MUST BE COMPLETED FOR NEW AND CONTINUING CONCURRENT STUDENTS.

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High School Officials

I have examined the academic records of the applicant and certify that he/she is eligible to satisfy high school requirements (including curricular requirements for college admission) no later than the spring of his/her senior year. As a result, I recommend that he/she be permitted to enroll for the following semester:

Fall 20 Spring 20 Summer 20

High School City / State Phone

High School Principal Signature Date High School Counselor Signature Date

Parent/Guardian

As parent/guardian of the applicant, I hereby give my permission for him/her to be enrolled as a concurrent student in both high school and OSU courses for the semester listed.

Parent/Guardian Signature Date

Applicant (Required Signature)

By my signature below, I:

1. Understand that withholding information requested or giving false information may make me ineligible for admission to, or continued enrollment at, Oklahoma State University.

2. Authorize any high school, university or college I have attended to furnish enrollment and/or grade information requested by OSU.3. Understand that I must maintain a minimum 2.00 college cumulative graduation/retention GPA to continue concurrent

enrollment at Oklahoma State University, and falling below that could affect full-time admission.4. Authorize Oklahoma State University to release midterm grades, attendance records and class schedule to my high school

counselors, principal or records office upon their request. 5. Understand that I must file a transcript request to send final grades to the high school if I wish to count hours toward high school

graduation. 6. Promise to fulfill all financial obligations to the institution which I may incur and will comply with all Board of Regents and

institutional policies or standards.

Applicant’s Signature Date Printed Name Date

Concurrent Applicant Form — Currently Enrolled at a U.S. High School

Attach your official high school course schedule to this form. This information is required to evaluate curricular requirements for admission to OSU.

Does your high school have block scheduling? o Yes o No

Affirming Accurate Information Statement (For Returning Students Only)

o I am a continuing concurrent student and verify all information in my previous concurrent application is accurate.

Signature OSU ID No. (CWID)

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NAME: _______________________________________________ BIRTH DATE: _ _ / _ _ / _ _ _ _