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

  • Yes
  • No

What is your citizenship status?

  • Citizen of United States
  • Non-Resident Alien
  • Resident Alien
  • Unknown


  • Female
  • Male
  • None
  • Unknown

Race (Choose one or more)

  • White
  • Native Hawaiian or Other Pacific Islander
  • Black or African American
  • Asian
  • American Indian or Alaska Native


  • Not Hispanic/Latino
  • Hispanic/Latino

Select YOUR Marital Status

  • Divorced
  • Married
  • Single
  • Widowed

Do you reside in the United States?

  • Yes
  • No
Have you taken the ACT or SAT? Cumulative Score on ACT/SAT?
State of Institution Institution Name of Institution Degree Institution Start Date Institution End Date
Activities/leadership positions held Specify Grade/College (check all that apply)

Specify Grade/College (check all that apply)

  • Freshman Year
  • Sophomore Year
  • Junior Year
  • Senior Year
  • College

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

  • Yes
  • No

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

  • Yes
  • No