If you have attended additional institutions, please use the box below to type in the names of those institutions, the dates you attended, degrees you earned and when you earned them, semester hours completed, and semester hours currently enrolled. I understand that withholding information requested on this application or giving false information may make me ineligible for admission to the University or subject to dismissal. I certify that the statements I have made on this application are correct and complete. Notice Southern Illinois University Edwardsville is committed to equal educational and employment opportunity and affirmative action. SIUE administers its academic programs without regard to race, ethnicity, color, sex, creed or religion, national origin, age, handicap, veterans' status or other proscribed categories.
Affirmative action is taken as appropriate.
In addition, it is the policy of SIUE to make every reasonable effort to accommodate individuals with special needs. The University complies in letter and spirit with federal and state legislation, which includes, but is not limited to, Titles VI and VII of the Civil Rights Act of 1964, Executive Order 11246, the Equal Pay Act of 1963, the Age Discrimination in Employment Act of 1967, Title IX of the Education Amendments Act of 1972, Sections 503 and 504 of the Rehabilitation Act of 1973, the Vietnam Era Veterans' Readjustment Assistance Act of 1974, Titles VII and VIII of the Public Health Service Act, and the Illinois Human Rights Act and related state laws. Inquiries regarding equal opportunity and affirmative action in admission and administration should be directed to the office of the Provost and Vice Chancellor for Academic Affairs. GS Term Residency R N Class G Your signature is required before we can process your application.