High School Bridge Program Application/Registration Form
The Pace Bridge Program is specifically designated for currently enrolled high school juniors and seniors who are
interested in taking a 100-level academic course at Pace University. All students must be in good academic standing
and have written approval from their guidance counselors. The tuition is $150 per credit hour* and courses are offered
at Pace University during the fall, spring, and summer semesters (bridge courses taught at a high school are only
offered in fall and spring). To determine eligibility, each student must submit an application/registration form, letter of
recommendation from his/her guidance counselor or principal, and an official high school transcript.
PERSONAL INFORMATION
O Mr.
O Ms.
Last Name
First Name
-
Middle Name
Jr., III, etc.
-
/
Social Security Number
/
Date of Birth (MM/DD/YYYY)
Address
Apt. #
City
State
Zip/Postal Code
Country
E-mail Address
(
)
-
(
)
-
O Male O Female
Home Phone Number Cell Phone Number Gender
ACADEMIC INFORMATION
List the high school you are currently attending.
.
Name of high school
Current GPA
Expected date of graduation_________________________________________________
City
State
(
Guidance Counselor’s Name
)
-
Guidance Counselor’s Phone Number
COURSE SELECTION
• Select a course from approved High School Bridge course list
• Refer to Schedule Explorer at www.pace.edu/classschedule for course reference number, department, and class number
Please indicate the semester you plan to attend: Fall 20
Spring 20
Summer 20
You are selecting a course for the upcoming semester only. To take additional courses in future semesters, you will need to reapply to the Office of Admission.
Course Reference Number
Department
Class Number
Campus selection (please select one)
O New York City
O Pleasantville
A nonrefundable $150 per credit fee payable to Pace University will be charged to bridge students.
* Special course fees may apply
2013–2014
ADDITIONAL INFORMATION
Were you ever the subject of disciplinary action in secondary school or college?
O Yes
O No
Have you ever been convicted of or pleaded guilty to a misdemeanor or felony?
O Yes
O No
If yes to either, please explain on a separate sheet of paper. If answering yes, this does not automatically bar you from admission or registration to/at Pace University.
SIGNATURES
I certify that all of the information provided by me or on my behalf in support of my application for admission is complete and accurate. I acknowledge
that I am obligated to supplement my application as soon as I know or reasonably should know that the information I have provided or that was
provided on my behalf is inaccurate or incomplete. I also certify that the personal statement submitted in support of my application for admission
is solely my own original work. I acknowledge that Pace University may, at its sole discretion, verify any information submitted in conjunction
with my application. I acknowledge that if I omit relevant information or provide inaccurate information or information that is misleading, submit
a personal statement that is not solely my own original work, or if I fail to supplement my application as required, Pace University may, at its sole
discretion, deny my application for admission, rescind my admission, impose disciplinary sanctions against me, dismiss me from Pace University,
and/or rescind any degrees or certificates awarded to me by Pace University.
Applicant’s Signature
Date
Applicant’s Name (Please print)
Parent’s or Guardian’s Signature
Date
Parent’s or Guardian’s Name (Please print)
If the applicant is under 18 years of age, the application must be signed by the applicant’s parent or guardian.
ADMISSION OFFICE LOCATIONS
Please mail your completed application or drop it off at the appropriate Admission Office.
Office of Undergraduate Admission
Pace University
1 Pace Plaza
New York, NY 10038
(212) 346-1323
Office of Undergraduate Admission
Pace University
861 Bedford Road
Pleasantville, NY 10570
(914) 773-3746
Pace University is committed to achieveing full equal opportunity in all aspects of university life. Pursuant to this commitment, Pace University does not discriminate on the basis of gender,
race, age, ethnicity, marital or domestic partnership status, national origin, sexual orientation, religion, disability, or veteran status.
2013–2014
APPROVED PACE UNIVERSITY HIGH SCHOOL BRIDGE PROGRAM COURSES
ANT 101
Introduction to Anthropology
MAT 141*
Introductory Statistics for the Life Sciences
ART 101
Introduction to Arts
MAT 142*
Introductory Statistics for Psychology
CHI 101
Elementary Chinese I (Mandarin)
MAT 143*
Introductory Statistics for History and the Social Sciences
COM 114
Introduction to Mass Media
MAT 234*
Introduction to Probability and Statistical Analysis
CIS 101
Introduction to Computing
MAT 236*
Multivariable Calculus
CRJ 150
Introduction to Criminal Justice
MAT 238*
Linear Algebra
ECO 105
Principles of Economics: Macroeconomics
MAT 253*
Differential Equations
ENV 110
Nature and Culture: A Study in Connections
MAT 260*
History of Mathematics
FRE 101
Elementary College French I
PHI 110
Introduction to Philosophy
GLB 101
Introduction to Global Studies
PHI 115
Normative Ethics: Contemporary Moral Problems
HIS 104
History of Western Civilization I
PHI 116
Modern Philosophy
HIS 107
World Civilization I
POL 101
Politics: Comparative Introduction
HIS 119
The Middle East: An Historical Survey
POL 102
Public Myth and Ideologies
HIS 131
The Asian World: An Historical Survey
POL 111
American Government and Political Institutions
HIS 132
Africa: An Historical Survey
POR 101
Elementary Portuguese I
HIS 134
Modern Latin America
PSY 112
Introduction to Psychology
ITA 101
Elementary College Italian I
RES 101
Introduction to the Study of Religion
JPN 101
Elementary Japanese I
RES 106
Religions of the Globe
JRN 101
Introduction to News Media
RUS 101
Elementary Russian
JRN 105
Introduction to Broadcast News
SCI 101
The Planet Earth
LAW 101
Business Law I
SCI 110
The Physical World
MAT 103*
Algebra
SCI 130
Elements of Environmental Science
MAT 104*
Finite Mathematics
SCI 145
Environmental Geology
MAT 111*
Elementary Calculus
SCI 150
Astronomy
MAT 117*
Elementary Statistics
SOC 102
Introduction to Sociology
MAT 130*
Precalculus
SPA 101
Elementary College Spanish I
MAT 131*
Calculus I
THR 121
Introduction to Theater
MAT 132*
Calculus II
MAT 134*
Introduction to Probability and Statistics
MAT 137*
Introduction to Discrete Mathematics
*Approval is required prior to enrollment in course Last Revised April 2013
HIGH SCHOOL BRIDGE PROGRAM RECOMMENDATION FORM
TO BE COMPLETED BY BRIDGE APPLICANT (Please print)
Name of Applicant _____________________________________________________________________ Birth Date___________________________________
Last
First
Middle
School Now Attending ______________________________________________________________________________________________________________
CONFIDENTIALITY STATEMENT
Under the provisions of the Family Educational Rights and Privacy Act of 1974 (Buckley Amendment), you have the right to review your educational records if you attend Pace
University. You may waive your right of access to this specific recommendation if you choose. Your decision to waive or not to waive your right of access will have no effect on your
application for admission. Please check the appropriate box and sign your name below:
I hereby waive my right of access to this recommendation.
I do not waive my right of access to this recommendation.
TO BE COMPLETED BY PRINCIPAL OR COUNSELOR
How familiar are you with Pace University?
Very
Somewhat
Not at all
How long have you known the applicant?___________________________________
Appraisal of intellectual capabilities:
Appraisal of personal capabilities:
Signature
Date
Name (Please print)
School
School Address
Telephone Number
E-mail Address
HIGH SCHOOL BRIDGE PROGRAM RECOMMENDATION FORM
Applicant’s Signature _______________________________________________________________ Date___________________________________________
2013–2014