Jenzabar University

Culver-Stockton College Applications

This application is used if you are entering college as a first time undergraduate student even if you may have college credit through Dual Credit/AP credit courses in high school.  

Will you have your associate's degree completed before enrolling at C-SC?

Select One:

Please confirm - you are applying for admission as a first-time freshman:

Please confirm - you are applying for admission as a first-time international freshman:

Have you taken or are you currently taking Dual Credit or AP Courses during High School?

Transfer - This application is used if you are transferring to Culver-Stockton College after enrolling full-time at another college or university not counting dual-credit courses.

Select One:

Please confirm - you are applying for admission as a transfer student:

Please confirm - you are applying for admission as an international transfer student:

Re-Admission - This application is used if you previously attended Culver-Stockton College as an undergraduate student. 

Select One:

Please confirm - you are applying for admission as a re-admit student:

Please confirm - you are applying for admission as an international re-admit student:

PERSONAL INFORMATION

Required information is marked with a * (red asterisk) and must be completed before the form will submit.  If any required information is not applicable to you, enter N/A.

Prefix

First Name

Middle Name

Last Name/Surname:

Suffix

Preferred Name

Maiden Name (if applicable)

CITIZENSHIP INFORMATION

What is your citizenship status?

If not US citizen, citizen of

If you are here on a visa, please select type of visa?

Please list your TOEFL score

If your primary language is not English, please list it here

BIOGRAPHICAL INFORMATION

Please note, we respect your privacy in requesting the Biographical Information below.  The information collected will have restricted access but is required by the Registrar's Office and Financial Aid office for reporting and financial aid purposes.  

Gender

Birth Date

SSN

YOUR ETHNICITY (Optional)

Race (Choose one or more)

Ethnicity

ADDITIONAL INFORMATION (Optional)

Select YOUR Marital Status

Religious Preference

If Christian, are you a member of the Disciples of Christ denomination?

Click the link below to download the Disciples Award Information.  This form should be completed and returned to be eligible for the Disciples of Christ financial award.

2019-2020 Disciples of Christ Award

CONTACT INFORMATION

Do you currently reside in the United States?

All address information is required.  If any information is pre-populated, please make changes as needed.  

Enter any additional address information such as Province, Region, Postal Code, etc. required for international addresses in the Additional Address field.  Separate additional information with commas.

Address Line 1

Address Line 2

Additional Address

Zip Code

City

State

County 

Country

Cell Phone

International Phone Number

Email Address

Confirm Email Address

ENROLLMENT INFORMATION

Entering Year

(PLEASE NOTE: Options in drop down are for academic year which runs from August through May)

Entering Term

Full (12 credit hrs per semester) or Part-Time?

International Students:  A valid major is required for the I-20 paperwork.  UND (Undecided) is not acceptable.  Please select your intended major or one you are considering.

Please indicate the major or area of academic interest you are considering

Select Health Science Specialization

Master of Athletic Training Admission Routes - please read carefully and then select your option from the dropdown (only if you are pursuing MAT).

Direct Admission Accelerated (3 + 2) five year BS + MAT Degree -- ** Must have high school 3.5 GPA, 25 ACT and 50 hours AT observation prior to enrollment in BS.

Accelerated Admission (3 + 2) five year BS + MAT degree

Traditional (4 + 2) after completion of BS degree

Please select your intended route (please read descriptions above):

Select a Pre-Professional path if applicable

Select a Pre-professional path if applicable

Will you be a resident or commuter student?

FINANCIAL AID INFORMATION

Are you or a parent currently in the military or retired from military service?

Is your parent(s) or spouse an employee of Culver-Stockton College?

Name of employee

Is your parent(s)/spouse an employee of any college, other than Culver-Stockton College, participating in tuition benefits?  (see link to participating institutions above)

Name of participating college:

Do you have a parent, grandparent or sibling that attended Culver-Stockton College?

Please share the name and relationship of your relatives, using the name they used while attending C-SC.

What most encouraged you to apply to C-SC?

CONVICTION REPORTING

Have you ever been adjudicated guilty or convicted of a misdemeanor or felony?  Note that you are not required to answer "yes" to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise required by law or ordered by a court to be kept confidential.

If yes to the question above, please explain.

Your counselor will be in touch for further information.

PRIMARY PARENT/GUARDIAN INFORMATION

First Name:

Last Name:

What is relationship to primary parent?

Is the Primary Parent Home Address the same as your Legal Home Address?

Address:

Address Line 2:

City:

State:

Zip:

Country:

Cell Phone:

Email:

Would you like to add another Parent/Guardian?

SECONDARY PARENT INFORMATION

First Name:

Last Name:

What is relationship to secondary parent?

Is the Secondary Parent Home Address the same as your Legal Home Address?

Address:

Address Line 2:

City:

State:

Zip:

Country:

Cell Phone:

Email:

HIGH SCHOOL INFORMATION

Type of High School

State of Institution

Select mailing address city of institution

Institution

Name of Institution

High School Graduation Year

High School GPA

On a scale of

Name of High School Guidance Counselor

High School Telephone

Home School/GED Completion Date

Are you a participant in the Missouri A+ Program?

Culver-Stockton College is my

OTHER COLLEGE/UNIVERSITIES

List other college/universities you are applying to.  Click the Add Other College button to add another institution.

College/University:

Culver-Stockton is a test-optional school for 2020-21.  Do you plan to submit an ACT/SAT score?

ACT/SAT

Select the test code and enter your score.  Click Add Test Score.  You can submit both a SAT and ACT score.

Have you taken the ACT or SAT?

Highest Cumulative Score on ACT/SAT?

PREVIOUS COLLEGE

Enter all institutions you have previously attended (including Dual Credit institutions).  Please note, an official college transcript will be required from each institution listed during the application process.

State of Institution

Institution

Name of Institution

Degree

Institution Start Date

Institution End Date

Please complete the following question, if it does not apply to you, select No:

Are you a member of Phi Theta Kappa?

ATHLETICS

Please select your intended athletic participation at Culver-Stockton College.  Additional questions may apply.

Please select your athletic primary interest: 

Year(s) of Varsity/Club/Traveling Team experience:

Please select additional athletic interest: 

FINE ARTS

Do you intend to apply for a Fine Arts scholarship?

Please indicate Fine Arts primary area of interest: 

Please indicate an additional Fine Arts area of interest: 

Please indicate an additional Fine Arts area of interest: 

What instrument(s) do you play?

ADDITIONAL ACTIVITIES

Activities/leadership positions held

Specify Grade/College (check all that apply)

List the languages you speak including English.

Which language do you speak most fluently?

Have you taken the TOEFL?

If so, list your score:

Gender at birth

Did you attend Explore Nursing or Explore Health Sciences?

If not a US citizen, specify country of citizenship

Country of birth

If not born in the US, at what age did you move to the US (if applicable)?

How did you learn about Blessing-Rieman College of Nursing & Health Sciences (Check all that apply)

We can't wait to receive your application!

I certify that the information on this application is complete and correct, and I understand that the submission of false information is grounds for denial of my application, withdrawal of any offer of acceptance, cancellation of enrollment or any appropriate disciplinary action.  I authorize the College to verify the information I have provided with all the schools I have attended.  I agree to notify the proper officials of the institution of any changes in the information provided.  I give my high school(s) permission to send my official transcript(s) directly to Culver-Stockton College

I agree to give Culver-Stockton College the right to publish or announce information about scholarships or grants that I receive.

Please review and answer the following statements regarding collection of data by Culver-Stockton College.

Culver-Stockton College may communicate with me by mail, email, phone, or text message prior to or after submission of my application or inquiry.  You may withdraw consent by sending a notice to webmaster@culver.edu.

I understand and consent that all data collected will be used as specified in the Culver-Stockton College Privacy Policy.

By checking this box, I represent that (i) I am age 18 or older and (ii) I have read, understood and agreed to the terms and conditions of the  Privacy Policy (unless I am under the age of 18, in which case, my parent or legal guardian has also read, understood and agreed to the terms and conditions of the Privacy Policy).

Review your application and make sure all required questions are completed

Please check your application for all required information.  Required questions are preceded by a red *.  Your application will not submit if required questions are not completed.  

Once you submit your application, along with your transcripts and test scores, we'll send you a quick admission decision!