Application for Non-degree Seeking Students

First Name*

Last Name*

Other Last Names Used

Sex*

Male

Female

Intersex

Birthdate*

Mailing Address: *

Country

Street

City

Region

Postal Code

Cell Phone*

Personal Email Address*

Copy of your Passport

What is your Country of Citizenship? *

What is your Social Security Number? *

Please indicate the Ethnicity and Race(s) you consider yourself to be:

Ethnicity is based on the following categorization:

Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

Are you Hispanic or Latino?

Yes

No

Race is based in the following five categorizations:

American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black or African American: A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

Enrollment Information

Campus: *

On Campus

Online

Program of Interest: *

Undergraduate Level Courses

Graduate Level Courses

Enrollment Term: *

Are you working with any of the following enrollment partners? (If not, leave blank)

Current College/University that you will be transferring your credits to

Current College:

Final Section

Copy of your Passport (Upload)

Have you ever been suspended or dismissed from school?*

Yes

No

Please note that you will be asked to provide a written statement explaining when and why you were suspended or dismissed, in detail, to be reviewed by the Admissions Committee with your application.

Have you ever been convicted of a felony?*

Yes

No

Please note that you will be asked to provide a written statement explaining the nature of your conviction as well as any supporting public documentation, in detail, to be reviewed by the Admissions Committee with your application.

APPROVALS

Electronic Signature*

By submitting this form, I certify that I have carefully considered each question above and that my statements are true and complete to the best of my knowledge. I hereby authorize the release of my official transcripts to Tiffin University and authorize this institution to obtain any indicated test scores directly from the appropriate testing agency. I understand that knowingly submitting false information may warrant dismissal and prevent subsequent registration from Tiffin University.

Staff Assigned (Zac Ball) Hidden

Non Degree Application

Application for Non-degree Seeking Students