Dual Admission Intent Form

Dual Admission Always

Personal Info

First

Last

Do you have another first name you'd like to go by?

Yes

No

Your First Name

Birthdate

Email

Cell Phone

May we text you?

Yes

No

Mailing Address

Country

Street

City

Region

Postal Code

Gender

Primary Citizenship

U.S. Permanent Resident?

Yes

No

Are you Hispanic or Latino?

Yes

No

Please check one or more of the following groups in which you consider yourself to be a member:

Are you a current Pennsylvania resident who has lived in the state for more than 12 months?

Yes

No

Dual Admission Info

Which type of student you will be:

Transfer Undergraduate

When do you expect to enter Shippensburg University?

Program

Community College Info

Community College

Dual Admission Email Address

CEEB Code

Search Field to Find CEEB Code

Lookup your CEEB code by the location first.

Level of Study

I intend to graduate with what major:

Student ID

Start Date

Expected Graduation Date

High School from which you graduated:

Signature

Students may apply for admission under the Dual Admission Program as early as their senior year of high school but no later than the completion of 30 college-level credits in a transfer program offered through their community college(s).

Students enrolled in the Dual Admission Program must maintain continuous enrollment at their current community college, earn the associates degree and meet all Ship admissions requirements, including grade point average for their intended major.

Please inform your community college and Ship of any changes in your plans and update relevant personal information. If you attend another college/ university in addition to your current community college to complete college credits, you must request an official transcript(s) to be sent directly to Ship.

I authorize my current community college, which I have indicated on this form, and Ship to exchange necessary information regarding my matriculation and course work, including academic transcripts, at both institutions to facilitate the transfer from my current community college to Ship and to provide the information needed to evaluate the program. Such information will be reported in summary form so that no student will be identified individually.

Shippensburg University of Pennsylvania, in compliance with federal and state laws and university policy, provides equal educational, employment, and economic opportunities for all persons without regard to race, gender, age, ethnicity, national origin, religion, sexual orientation, or marital, veteran, or disability status. Direct requests for disability accommodations and other inquiries should be made to the Office of Social Equity, Old Main 109, Shippensburg University, 1871 Old Main Drive, Shippensburg, PA 17257-2299, (717) 477-1161

Today's Date

In place of signature, please type your full name: