Davis & Elkins College | Admissions & Financial Aid

Personal Background

Mr. Ms. Mrs.

First Name:

Middle Name:

Last Name:

Preferred Name:

Sex:

Male Female

Date of Birth:

Country of Citizenship:

Permanent Address:

City:

State:

Province:

County or Country

Zip or Postal Code:

Telephone:

Cell Phone:

Email:

Mailing Address if Different than Above

Address:

City:

State:

Province:

County or Country

Zip or Postal Code:

Academic and Educational Information

Applying As:

Full Time Part Time

Status:

Residency:

Term:

Have you applied to D&E before?:

Yes No

Intended Major:

Are you interested in the Honors Program?:

Yes No

High School:

Grad Year:

College(s) Attended:

Please name the college(s) and put the dates you attended in parenthesis like this example:
West Virginia University (2003-2004).

Tests:

Indicate the date(s) you have taken or will take the following tests.
(TOEFL is required if your native language is not English.)

SAT-1

ACT

TOEFL

Are you a Veteran?

Yes No

Honors/Awards:

List any high school and/or college academic awards or honors you have received (for example: Honors Society, Governor's School, National Merit, etc.):

Extracurricular, Athletic and Service Activities

List your extracurricular, athletic, fine and performing arts, community, church service, and employment activities. Indicate any awards or honors you have received. Include Individual, Team/Group, Honors, Awards, Accomplishments, Letters Earned, Musical Instruments Played, Championships Won, etc.

If you are interested in a sport or activity when you attend D&E please select below (choose as many as you like):

Sport:

Women's Basketball Women's Soccer Women's Cross Country
Softball Women's Volleyball Baseball

Men's Basketball Men's Cross Country Golf Men's Soccer

Extracurricular Activities:

Academic Organizations Honorary Fraternities

Literary Magazine Music:Instrumental & Vocal Groups

Radio Station Service Organizations

Social Sororities and Fraternities Special Interest Clubs

Student and Campus Government Student Newspaper

Theatre:Acting and Technical Yearbook

Scholarship and Financial Aid Information

Financial Aid:

Do you intend to apply for need-based financial aid? Yes No

Scholarships:

This information is not used for admission decisions.

Do you wish to be considered for any of the following scholarships? Select all that apply.

Academic Athletic Honors Leadership Music Theatre

NOTE: Fine and Performing Arts scholarships are available for both majors and non-majors, based on an audition or portfolio review.

Family Background Leave the address information blank if it's the same as above.

Father's Name:

Father's Occupation:

Number & Street:

City:

State:

Zip/Postal Code

Father's College(s) Attended:

List each college and the degree obtained:

Mother's Name:

Mother's Occupation:

Number & Street:

City:

State:

Zip/Postal Code

Mother's College(s) Attended:

List each college and the degree obtained:

With whom are you living?

Both Parents Mother Only Father Only

Other, please specify

Spouse Name, if applicable:

Number of Siblings:

Number of Siblings in College:

Has any member of your family ever attended Davis & Elkins College? Yes No

If yes, Name:

Relationship to You:

Graduation Year:

Optional Information

This information is optional and is not used for admission decisions, but is helpful for statistical reporting purposes.

How did you learn about Davis & Elkins College?

Have you met a D&E Admissions Counselor at your high school or at a college fair, if so who?

To what other colleges have you applied?

Your religious affiliation:

First language (if other than English):

How would you describe yourself? (check one)

American Indian or Alaskan   Asian
Hispanic (of any race)   Native Hawaiian or other Pacific Islander
Black or African American   White, Anglo, Caucasian (non Hispanic)

Multi-racial

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