Undergraduate Nondegree Application

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Email Address

Home Phone

Cell Phone

Emergency Contact Information

Please indicate the nearest relative or person to contact in case of emergency.

Relationship

First Name

Last Name

Email Address

Phone Number

Enrollment Information

Entrance Term

Last School Attended Information

School Name

City and State

Location

Degree

Graduation Date

Degree Completion Acknowledgment

Do you possess a High School Diploma or GED?

Yes

Non-degree students must possess a high school diploma or GED to gain admission at CSU. Any misrepresentation of credentials may cause for the University to deny and cancel admission and registration.

Electronic Signature

By submitting this application I certify that the information provided on this application is accurate, complete and subject to verification. I understand that all required application information will be evaluated for admission. I also understand that any misrepresentation or omission may be cause for the University to deny and cancel admission and registration, revoke financial aid, refuse posting of transfer credit and suspension from the University if discovered subsequently. I authorize for each high school, college or university I have attended to release my academic information to Cleveland State University. Please note that all Credentials submitted in support of your application become the property of Cleveland State University and will not be released under any circumstance.

Signature

Date

Undergraduate Nondegree Application

Personal Information

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