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Transfer Student Inquiry Form

Fields marked with an (*) are required for correct submission of this form. 

 
           Name:(*)        
                     First            Middle            Last
     
         E-mail:     

        Address:(*)  Street
        	     
                     

                     City 
                     
                     State   Zip          
                         
                     
                   
      Telephone:                  Gender:  Female Male
 
        Date of 
          Birth:     //
      
  Enrolling for:(*)  Fall  Interim  Spring  Summer

        of year:(*) 

Previous Colleges/
   Universities:(*)  
     				 
     				 

    High School:     
 
  Graduation Yr:                                 GPA:  
 
  ACT Composite:                         SAT Composite:  

 
     Class Rank:                         Class Size:  
               
       Academic                            
      Interests:
                     

     NOTE: Select as many as applicable. To make multiple selections hold down the
     Command key (Mac) or CNTL key (Win).         

    Extracurricular
      Interests:
                     

      Religious
     Preference:

Augustana College continually works to ensure equal opportunity in the conduct of all business activities without regard to an individual's age, color, handicap, national origin, race, religion, sex or veteran status.