Rome City/Jacksonville University Joint Application

Program Interested In

Enrollment Status

I Plan to Take Classes Full Time (12 or more Credits)

I Plan to Take Classes Part Time (11 or less Credits)

*You have selected the "Graduate (Non-Degree) option. To qualify for this program, you must have a conferred Undergraduate Bachelors Degree by the time you plan to start this pathway.

Highest Degree Achieved (by time of Rome City Institute Program Start):

You do not currently qualify for the program you have chosen above, please adjust your answer to submit your application.

Personal Details

First (Given) Name
This field is used to create your JU username and will be used on all official communication to you and your family from the university.

Preferred First Name
This field is used to create your JU username and will be used on all official communication to you and your family from the university.

Last (Family) Name

Names on previous academic records (if different)

Date of Birth

Sex at Birth

If you would like, you may share your gender identification below

Email Address

Mobile Phone

Primary Citizenship

Secondary Citizenship

Are you a Permanent Resident of the United States of America?

Yes

No

Social Security Number (No Dashes)
Jacksonville University collects social security numbers from its applicants to verify financial aid eligibility and to comply with federal higher education requirements.

Address

Country

Street

City

Region

Postal Code

Placeholder

Academic History

DeletePrevious Institution _ID_
Institution Information
Institution Dates Attended to Level CEEB Country Street City Region Postal Code

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Certification

I certify that all of the information submitted in the application is my own work, factually true, and honestly presented. I authorize all schools attended to release all requested records and authorize review of my application. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I certified be false.

* Signature:

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Rome City/Jacksonville University Joint Application