Undergraduate Application for Admission
 

Please complete the Application below. A $50.00 non-refundable fee must be paid to the Office of University Admissions, Western Connecticut State University, 181 White Street, Danbury, CT 06810. The $50 application fee may be paid online after the form has been completed. A check, money order or credit card authorization will also be accepted as payment. Please do not send cash. Please clearly identify the payment with studentís name.

Required fields are marked with *.

Before submitting the application, please make sure you remember to:

  • submit the $50.00 application fee or fee waiver (if payment is not made online)
  • submit a high school transcript request to your high school guidance counselor
  • submit a transcript request from any college(s) attended (if applicable)
  • submit 2 letters of recommendation from teachers, guidance counselors, or employers? (required for Freshman and Fresh Start applicants - optional for transfer and re-entry students)
  • request SAT I scores to be sent to Western Connecticut State University College Board Code #3350
  • enclose optional personal essay

*Is this your first application to Western Connecticut State University?
     Yes  No
If no, what is the approximate date of previous application?
Month:   Year:

*Social Security Number:
Previous (Maiden) Name:
*Legal Name (Last, First, MI):
*Legal Address (Street Address):
*City: State:*   Zip:*
Country (if outside USA):
Previous Address:
*How Long at Current Address?
*Home Phone Number:
*Work Phone Number:
*Best Time to Reach You:
*Date of Birth: / /
*Place of Birth:
*Email Address:
  Send a copy of this application to the email address above
*Emergency Contact:
*Emergency Phone Number:


Citizenship:
    
US Citizen     Permanent Visa     F-1 Student Visa     F-2 Student Visa     Other Visa Status

*Alien Information: Do you hold an Alien Registration Receipt Card (Green Card)?
     Yes     No 
If yes, please send a photocopy of both sides of your Green Card to the address above.
Alien #:


In order to meet State and Federal requirements, we are requesting that you voluntarily supply the following information. This data will not be used for discriminatory purposes and will not be considered in the evaluation of your application.

Gender:
    
Male     Female

Ethnic Group:
  American Indian Black Asian
  Hispanic White Other

Is English your native language?
     Yes
     No


*Applying For:
     Full-Time     Part-Time     Evening     Day

*Semester:
     Fall     Spring
     Year:

*On-Campus housing information requested?
     Yes     No

*Co-op education information requested?
     Yes     No

If you are not a High School Graduate, have you received your GED?
     Yes
     No
Date Received:
Test Center Name:
Test Center Address:  City:     State:

*Type of Application:
     Freshman
     Transfer Student
     Internal Transfer
     Re-Entry to WestConn
     Fresh Start (
Important Information)

*Testing Information
Please indicate when you completed or when you plan on taking the SAT.  The results must be sent directly to the Office of the University Admissions from the Educational Testing Service, Princeton, New Jersey (College board code #3350).  Western encourages students to take the SAT's in November, December or January of their senior year.  The highest score will be used to determine admission.

     SAT     ACT

          Date:
          Date:
          Date:

     TOEFL

          Date:


Student Education Information
*Name of High School:
*Address (Number and Street): 
*City: State:*   Zip:*
*Year/Graduation:
HS CEEB Code:

Transfer and Re-Entry Applicants Only - List Institutions Previously Attend

*An official transcript is required for each college attended.
Name:  Date Attended: 
Degree Earned or Credit Hours:
 
Major Programs: 
 
Name:  Date Attended:
Degree Earned or Credit Hours:
 
Major Programs: 
 
Name:  Date Attended:
Degree Earned or Credit Hours:
 
Major Programs: 
 
Name:  Date Attended: 
Degree Earned or Credit Hours: Major Programs: 
  
Courses in Progress:
Course # Title of Course Course # Title of Course


*Academic Major Selection - please number your first, second and third choices. (1,2,3)

Specialized Programs:
Would you like to be considered for the Honors Program?
     Yes     No

I am interested in the following professional advisement:
     Pre-Law     Pre-Health Professions Program

I am interested in the 5-week summer program Educational Access & Achievement Program (EA2 P)
     Yes     No
 

Important Information

For Residents of New England Only
Students who are legal residents of any other New England state may be eligible
for reduced tuition and fees under the "New England Regional Program."

Please check appropriate Western Program box below if applying
under the New England Regional Program:

     American Studies - Open to residents of Rhode Island and Vermont.

     Communications/Media - Open to residents of Maine and Rhode Island.

     Community Health Education - Open to residents of Massachusetts, Rhode Island, and Vermont.

     Criminal Justice/Criminology - Open to residents of New Hampshire.

     Earth Science/Astronomy Focus - Open to residents of Rhode Island and Vermont.

     Health Education - Open to residents of Vermont.

     Management Information Systems - Open to residents of Maine.

     Medical Lab Technology - Open to residents of Vermont.

     Meteorology (Forecasting) - Open to residents of Maine, Massachusetts, and Rhode Island.


List name(s) of any relatives that attended WCSU:


How did you first learn about WCSU?
     Friend
     College Fair
     Admissions Counselor
     Mail
     Guidance Counselor
     Other:
Newspaper Ad
Radio Ad
Alumni
Internet

Please check the most important factor(s) that attracted you to WCSU:

     Tuition Costs
     Location
     Academic Programs
     Financial Aid
     Reputation
     Internship Program
     Other

Housing Availability
Quality of Faculty
Hands On Experience
Academic Support System
Athletic Programs
Career Focus

To what other college(s) have you considered applying?

Extracurricular Activities: Years Participated:

Athletic Activities Years Participated:

After clicking the Submit Application button, it will take a few moments to process the form.  If any required information is missing, you will be prompted to enter it.  Please wait for a confirmation to appear -- do not click the Submit Application button more than once.  If you experience any technical difficulties please send an email to webmaster@wcsu.edu.