Culver-Stockton College Online Campus Application
Complete this application to apply for admittance to the Culver-Stockton College Online Campus Program.
Culver-Stockton College offers Online Campus Degrees in:
PLEASE NOTE: AT THIS TIME BUTTONS DO NOT WORK PROPERLY WHEN USING THE MICROSOFT EDGE BROWSER - THIS WILL BE FIXED SOON. PLEASE USE GOOGLE CHROME OR INTERNET EXPLORER WHEN COMPLETING THE FORM.
If you have questions about the online program which you are applying, please contact one of the following individuals.
Kaylee Jones (Assistant Registrar and Online Academic Advisor) - firstname.lastname@example.org
Shauna Jackman (Admission Counselor for Online/Graduate Programs) - email@example.com
If you experience technical problems with the submission of your application, please contact Cindy McCutchan, firstname.lastname@example.org in the Information Technology Department. Please provide the following information in support email: Device used in submitting application (mobile phone, laptop/desktop, iPad, etc.), browser used, error received or screen shot of error received.
Please indicate if you have previously attended Culver-Stockton College either as an undergraduate or online student. Entering your C-SC id number will pre-populate information on several screens. Please make any updates as necessary to the populated 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.
Have you previously attended Culver-Stockton College?
Enter C-SC ID Number (if known)
Name previously attended under
What song do you wish you had on your phone right now? (Please also list name of recording artist)
Do you reside in the United States?
All address information is required. Entering the zip code should populate the city and state. 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
International Phone Number
Confirm Email Address
What is your citizenship status?
If not US citizen, citizen of
Please list your TOEFL score
If your primary language is not English, please list it here
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.
Race (Choose one or more)
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
(PLEASE NOTE: Options in drop down are for academic year which runs from August through May)
As a First Time College student, do you have college credit from Dual Credit classes?
Are you currently enrolled at Culver-Stockton College in the traditional undergraduate program?
List Program of Interest
How did you hear about our program?
If Other, please explain:
FINANCIAL AID INFORMATION
Will you be completing the Free Application for Federal Student Aid (FAFSA)?
Are you or a parent currently in the military or retired from military service?
Does your current place of work provide tuition assistance?
If yes, enter your employer's name
High School Information
Type of High School
Did you graduate from High School prior to 2013?
State of Institution
Select mailing address city of institution
Name of Institution
High School Graduation date
High School GPA
On a scale of
Name of High School Guidance Counselor
High School Telephone
Home School/GED Completion Date
Have you taken the ACT or SAT?
Score on ACT/SAT?
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.
Institution Start Date
Institution End Date
BAAS ONLY INFORMATION
Please list any military field experience
List any professional training
Will you be submitting experience documentation to the Office of Online Learning?
Experience Documentation Needed
Please include the following in your documentation:
Documentation may be forwarded to Robin Jarvis, director of the Office of Online Learning (email@example.com).
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 firstname.lastname@example.org