Application for Undergraduate Admission and Scholarships
We are excited and pleased that you are applying to Southern Illinois University Carbondale, a research extensive university with a proud history of academic achievement. By completing this
application, you are applying to a university ranked among the “Best National Universities” by US News and World Report. Undergraduate Admissions and Transfer Student Services are available
to assist you at any time during the application process, and we encourage you to avail yourself of their experience and expertise.
Best wishes,
Dr. John W. Nicklow, Provost and Vice Chancellor for Academic Affairs
Please print in ink.
o Yes o No Date last attended: Month
Do you plan to attend classes at our Carbondale Campus? o Yes o No
Have you previously attended SIU Carbondale?
Last
Year
First Middle
(Please use legal name.)
Any other name your records may be under
Permanent Address City
State
Have you resided in Illinois for the 6 months immediately preceding the date of this application?
Gender:
o Male o Female
Zip Code
o Yes o No
Birth Date: Month
Day
Year
Why do you ask for my social security number? Your Social Security Number (SSN) is requested pursuant to Public Law 93-579 for the University’s system of student
records, as well as for compliance with federal and state reporting requirements. An SSN is required if you are applying for financial aid but is not required for admission to
the University. Supplying an SSN ensures that you will be able to claim the Hope Tax Credit, if you are eligible, on your federal tax return.
Social Security Number:
Telephone Number ( _________ )
May we contact you through cell phone text messaging?
Cell Phone Number ( _________ ) o Yes o No
Complete E-mail Address
Parent 1 Name______________________________________________________________________________________________________________________
Address_ _____________________________________________ Phone ( _________ ) _________________ Email_______________________________________
Parent 2 Name______________________________________________________________________________________________________________________
Address_ _____________________________________________ Phone ( _________ ) _________________ Email_______________________________________
o U.S. Citizen
o Foreign/International
Country of Citizenship____________________________________________________________
o Permanent Resident (non U.S. Citizen) Type of Visa__________________________________________________________________
o Other o Requesting consideration under Illinois Public Law 93-0007 (This applies to undocumented persons graduating from an Illinois high school)
Have you applied for Deferred Action for Childhood Arrivals? o Yes o No
Citizenship:
Ethnic information is requested so that this institution may demonstrate its compliance with federal requirements. Your response will not affect the admission decision.
Ethnicity: Are you Hispanic or Latino/Latina (Hispanic or Latino means a person of Cuban, Mexican, Puerto Rican, South or Central America, or other Spanish culture origin,
regardless of race)?
o Yes o No
Which best describes you? (check all that apply):
o American Indian or Alaskan Native o Asian o Black or African American o White o Native Hawaiian or other Pacific Islander
The application term may be changed one time per application, provided the request is made prior to the start of the original application term.
Applying for (year):______________________ Type of student:
o Fall o Spring o Summer o Summer Only
o Freshman o Transfer o Re-entry
Name of high school from which you graduated (or will graduate)
City
Guidance Counselor Name
Dates of Attendance: From
State
Zip Code
Guidance Counselor Email
Month/Year To
Month/Year
Graduation Date:
Month/Year
Have you attained a G.E.D.?
Undergraduate Admissions 1263 Lincoln Drive | Mail Code 4710 | Southern Illinois University | Carbondale, Illinois 62901 | (618) 536-4405
o Yes o No
List all high school course work that you are currently, or will be enrolled in, before you enter SIU. (attach additional page if needed)
Subject Area
Course Name
Semester
o Fall
o Fall
o Fall
o Fall
o Fall
_______________ _ ____________________________________
_______________ _ ____________________________________
_______________ _ ____________________________________
_______________ _ ____________________________________
_______________ _ ____________________________________
If you are in high school, have you taken, or will you take, any college level courses prior to graduation?
o Spring
o Spring
o Spring
o Spring
o Spring
o Both
o Both
o Both
o Both
o Both
o Yes o No
If yes, list all college courses you are currently enrolled in, or will be enrolled in, and will have completed before your enrollment at SIU. (attach additional page if needed)
Institution
Course Title
Semester Hours
____________________________________ _____________________________________________ ______________________________
____________________________________ _____________________________________________ ______________________________
____________________________________ _____________________________________________ ______________________________
____________________________________ _____________________________________________ ______________________________
____________________________________ _____________________________________________ ______________________________
In what major are you interested? _______________________________________________________________________________________ (see list on back of application)
Do you plan to teach?
o Yes o No
If yes, have you taken the Illinois Test of Academic Proficiency (formerly Basic Skills Exam)?
Have you attended other colleges or universities since high school graduation?
FOR STUDENTS WITH PRIOR COLLEGE COURSEWORK
Have you already earned an Associate’s degree?
o Yes o No
o Yes o No
o Yes o No
o Yes o No
If yes, please complete the following:
Have you already earned a Bachelor’s degree?
o Yes o No
Do you have, or will you earn, an AAS degree or certificate?
List all colleges attended and dates. (attach additional pages if needed)
Name of Institution (begin with most recent)
City
State
Are you registered for the current or future terms?
o Yes o No
From
Dates of Attendance
Hours
Completed
To
/
–
/
/
–
/
/
–
/
/
–
/
/
–
/
If yes, for how many hours are you registered? ____________________
The Dual Admission Program (DAP) is only for students who will be attending a community college prior to transferring to SIU. DAP assists students who have selected a specific major and plan to
transfer to SIU to complete a Bachelor’s degree. Participants receive an academic plan detailing all courses required to complete a specific baccalaureate degree program at SIU. Included in the plan is
a list of community college courses that can be substituted for SIU coursework. The student receives feedback in the form of a semester-by-semester transfer credit evaluation report of their community
college coursework, in addition to other program benefits
Would you like to participate in the Dual Admission or Dual Degree Program?
Have you served, or are you currently serving in the U.S. Armed Forces?
o Yes o No
o Yes o No
If yes, list dates of active service. Month______ Year__________ to Month______ Year__________
Has either of your parents (or step-parents, if they are primary) received formal education: Beyond high school o Yes o No
o Yes o No
o Yes o No
Are you interested in the University Honors Program? o Yes o No
Are you interested in being considered for academic scholarships? o Yes o No
Do you intend to apply for financial aid? o Yes o No
Do you intend to enroll full time? o Yes o No
Is your parent/step-parent/legal guardian a graduate of SIU Carbondale?
Are you related to an SIU Carbondale employee?
Received a bachelor’s degree o Yes o No
PUBLIC SAFETY QUESTIONS
Southern Illinois University Carbondale is committed to maintaining a safe environment for our students. Answering “Yes” to any of the following questions will not automatically prevent admission. All
applications are reviewed.
Have you pled guilty or no contest to, or been convicted of a felony?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . o Yes
Have you ever pled guilty or no contest to, or been convicted of any crime involving violence or the threat of violence?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . o Yes
Do you have any criminal charges pending against you involving a felony, violence, or the threat of violence?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . o Yes
Have you ever been expelled, dismissed, placed on probation or suspension, or subjected to any other
disciplinary sanction from any other college or university for an offense involving violence or the threat of violence?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . o Yes
o No
o No
o No
o No
If you answered “Yes” to any of the questions above, please do the following:
1. Write an explanation of the circumstances, including your name and date of birth
2.Request that the Circuit Clerk of the Court(s) in which the order of conviction was entered send a copy of your records
3.Send, or have the Court send, these items to:
Enrollment Management
Attn: Campus Violence Prevention Committee
c/o Dean of Students
Southern Illinois University Carbondale
Mail Code 4308
1263 Lincoln Drive
Carbondale, Illinois 62901
IN ORDER FOR THIS APPLICATION TO BE COMPLETE, YOU MUST SIGN THE STATEMENT BELOW AND ENCLOSE THE $40 APPLICATION FEE.
Applications cannot be processed without the $40 application fee. This fee is nonrefundable. DO NOT enclose the $40 application fee if you are a Re-Entry applicant. Students who have previously
attended SIU are not required to pay the fee. The application fee may be paid via check or money order (payable to Southern Illinois University Carbondale).
Method of payment:
o Check o Money Order
Credit cards or cash will not be accepted with the printed application.
It is the student’s responsibility to request all official transcripts, test scores and supplemental documents. Please submit this Undergraduate Admission Application and $40 non-refundable application fee to:
Undergraduate Admissions
Mail Code 4710
1263 Lincoln Drive
Carbondale, IL 62901
CERTIFICATION STATEMENT TO BE SIGNED BY APPLICANT
I certify that the statements made on this application are correct and complete including a report of all possible collegiate credit and criminal history as described above. I understand that withholding
information requested on this application or giving false information may make me ineligible for admission to SIU or subject to dismissal. I agree to maintain an accurate mailing and electronic address
to which my statement of account can be mailed and to make payment of all due amounts by published deadlines. If my account becomes delinquent, I understand that my account may be placed with
a collection agency and could be subject to litigation, and I agree to pay all associated costs. Further, I understand and agree that my unpaid tuition and receivables account is considered an extension
of credit and creates a loan due the university. I authorize SIU to maintain all my records under my legal name and understand these records and credentials in support of my application are the property
of SIU and will not be returned or reproduced. I give my permission to officials at all institutions I have attended to release information needed by SIU to substantiate statements I have made on this
application. I give my permission to SIU Department of Public Safety to conduct a criminal background check, if I answered affirmatively to any of the Public Safety questions on this application.
Signature
Date
SIU ACADEMIC PROGRAMS
SPECIALIZATION/OPTION LISTING
Accounting
Africana Studies
Agribusiness Economics
Agricultural Systems and Education
Agricultural Communications
Agricultural Education
Agricultural Systems
Technology Management
Agriculture Production
Management
Food and Process Engineering
Technology
General Agriculture
Animal Science
Equine Science
Production
Science and Pre-Veterinary
Anthropology
Architectural Studies
Art v
Art History
Ceramics
Communication Design
Drawing
General Studio
Glass
Industrial Design
Metalsmithing
Painting
Printmaking
Sculpture
Automotive Technology
Aviation Flight z
Aviation Management
Aviation Technologies
Aircraft Maintenance
Aviation Electronics
Helicopter Maintenance
Behavioral Analysis and Therapy
Biological Sciences v
Biomedical Science
Ecology
Business and Administration n
Business Economics
Chemistry
American Chemical Society
Certification
Biochemistry
Business
Comprehensive Chemistry
Environmental Chemistry
Forensic Chemistry
Cinema and Photography
Cinema
Photography
Civil Engineering
Environmental Engineering
Majors
Crop, Soil, and Environmental Management Industrial Technology
Crop Production and Management
Soil Science
Manufacturing Technology
General Design
Early Childhood v
Child and Family Services
Preschool/Primary
Advertising/Integrated
Marketing Communications
New Media News Production
News-Editorial
Photojournalism
Sports Media
Dental Hygiene
Design
Economics
Financial Economics
General Economics
International Economics
Law and Economics
Electrical Engineering
Electronic Systems Technologies
Electronics Management
Elementary Education v
Engineering Technology
Electrical Engineering
English v
Creative Writing
Literature
Pre-professional
Exercise Science
Exploratory Student Advisement
Fashion Design and Merchandising
Fashion Design
Fashion Merchandising
Fashion Stylist
Finance
Financial Institutions
Financial Management
Investments
Fire Service Management n
Forestry
Forest Hydrology
Forest Recreation and Park
Management
Forest Resources Management
Urban Forest Management
Wildlife Habitat Management
and Conservation
Geography and Environmental
Resources
Climate and Water Resources
Environmental Sustainability
Geographic Information Science
Geology
Environmental Geology
Geophysics
Resource Geology
Health Care Management
Health Education v
Community Health Education
History v
Horticulture
Production Horticulture
Landscape Horticulture
Turfgrass Management
Communication Disorders and Sciences v
Computer Engineering
Hospitality and Tourism Administration
Computer and Electrical Engineering
Event Planning and Management
(dual degree)
Computer Science
Criminology and Criminal Justice
Food Service Management
Lodging Management
Tourism Management
Human Nutrition and Dietetics
Information Systems Technologies
Interior Design
Journalism
Languages, Cultures, International
Studies
Classics
East Asian Language and Culture
Foreign Language and
International Trade
French
French-Teacher Education*
German
German-Teacher Education*
International Studies
Spanish
Spanish-Teacher Education*
Linguistics
English as a New Language
Management
Entrepreneurship
Global E-Business
Management of Health
Care Enterprises
Personnel Management
Supply Chain Management
Marketing
Mathematics v
Mechanical Engineering
Microbiology
Mining Engineering
Geological Engineering
Mortuary Science and Funeral Services
Music v
Liberal Arts-Music
Music Business
Music Education
Music Theory-Composition
Performance-Guitar
Performance-Instrumental
Performance-Keyboard
Performance-Voice
Piano Pedagogy
Studio Jazz Performance
Musical Theater
Paralegal Studies
Pre-Law
Philosophy
Pre-Law
Physical Education v
Physical Therapist Assistant z
Physics
Biomedical Physics
Computational Physics
Materials and Nanophysics
Physiology
Plant Biology
Ecology
Molecular and Biochemical
Physiology
Systematics and Biodiversity
Political Science
International Affairs
Pre-Law
Public Service
Psychology
Radio, Television and Digital Media
Digital Media Arts and
Animation
Electronic Journalism
Electronic Sports Media
Media Industries
Production-Radio/Audio,
TV/Video
Radiologic Sciences
Diagnostic Medical Ultrasound
Education and Management
Magnetic Resonance Imaging/
Computed Tomography
Radiation Therapy Technology
Recreation
Leisure Services Management
Outdoor Recreation Leadership
and Management
Therapeutic Recreation
Pre-Veterinary Medicine
Wildlife Biology and Conservation
PRE-PROFESSIONAL
NON-DEGREE PROGRAMS
Exploratory Student Advisement
Pre-Chiropractic
Pre-Dentistry
Pre-Engineering
Pre-Law
Pre-Medicine
Pre-Music
Pre-Nursing
Pre-Occupational Therapy
Pre-Optometry
Pre-Pharmacy
Pre-Physical Therapy
Pre-Physician Assistant
Pre-Podiatry
Pre-Veterinary Medicine
ROTC
Aerospace Studies (Air Force ROTC)
Army Military Science (Army ROTC)
MINORS
(Most majors are also available as a minor.)
Aerospace Studies (Air Force ROTC)
Air Traffic Control
Aircraft Product Support
Rehabilitation Services
Airport Management and Planning
Social Science v
American Sign Language
Social Work
American Studies
Sociology
Animation
Special Education v
Aquatics
Speech Communication
Army Military Science (Army ROTC)
Intercultural Communication
Asian Studies
Interpersonal Communication
Child and Family Services
Organizational Communication
Chinese
Performance Studies
Classical Civilization
Persuasive Communication
Coaching
Public Relations
Dance
Sport Administration
East Asian Civilization
Environmental Studies
Technical Resource Management
Equine Studies
Health and Safety Management
Forensic Science
Organizational Development
GIS
Professional Construction
Global Studies
Management
Greek
Theater
Japanese
University Studies
Kinesiology
Workforce Education and Development
Latin
Business, Marketing, and
Latino and Latin American Studies
Computer Education v
Career and Technical Education v Museum Studies
Native American Studies
Education, Training and
Peace Studies
Development
Photography
Family and Consumer Sciences v
Sustainability
Health Careers v
Television Studies
Technology Education v
Visual and Screen Cultures
Zoology
Women, Gender and Sexuality Studies
Animal Biology
Environmental Biology
Fisheries Biology and Aquatic
Conservation
v Teacher certification program available.
z Associate degree program; can lead toward Bachelor’s degree or
third-year specialization beyond Associate’s.
n Offered off-campus only.