Wittenberg University Adult/Non-Traditional Online Application

Please check:
Matriculant (Degree-seeking)
Nonmatriculant (Nondegree)
Status Change: Nonmatriculant to Matriculant
Readmit (former Wittenberg student)
Lifelong Learner (Age 60+)

Section 1

Name: (last, first, middle)
Preferred Name:
Home Address:
Zip Code:
Home Phone Number:
Cell Phone Number:
E-mail Address:
Social Security Number:

Section 2

Date of Birth: (month/date/year):
Gender: Female Male
Eligible for VA Benefits? YesNo
Work Phone Number:
Employer City:
If you are not a U.S. citizen, list your country and visa status:

Section 3

Have you ever been convicted of a felony or serious misdemeanor? YesNo
If yes, please submit a detailed explanation.
A conviction does not automatically disqualify an applicant; we will consider such factors as the seriousness and date of the offense and evidence of subsequent rehabilitation. Any misrepresentation on this matter subjects the applicant to immediate dismissal from the University without financial refund or credit.

Section 4

Ethnicity (optional):
Please check all that apply:
American Indian or Alaska Native                Asian American    African American   
Hispanic American   Native Hawaiian or Other Pacific Islander    White/Caucasian

Section 5 - Status, Schedule Preferences, and Term of Entry or Re-entry

Part-Time Evening/Weekend
Full-Time (12+ credits/semester)    Day

Fall Semester             Spring Semester
Summer Term        

Section 6 - Major Field of Academic Interest

   Accounting (BA)
   Criminology & Criminal Justice (BA)
   Liberal Studies (BA)
   Organizational Leadership (BA)
   Nursing: RN to BSN (BSN)
   Certificate in: 
      Organizational Leadership
      Human Resources
   Intended Major?     
Which degree do you seek?
     BA   BFA   BME   BS   BSN   No degree non-degree coursework only
If pursuing teacher licensure, in what area?
Teacher Licensure (Post-Baccalaureate only):
     Early Childhood
     Middle Childhood
     Intervention Specialist
     High School (list subject area)
Nondegree Coursework

Section 7 - High schools, technical/business schools, or colleges attended:

Include the name of the institution, city and state, years of attendance,
and what degree or diploma you received.

Section 8 - Brief Personal Essay:

Please write a brief statement about why you are deciding to begin or return to college and why you are selecting Wittenberg. Include your academic, career, and personal goals and any personal reflections that illuminate your situation at this important time in your life. Your statement should be at least 250 words in length.
Hint: You might find it helpful to write or type your statement on paper before you enter it into the box. Note that the box "expands" indefinitely so that your statement will easily fit. If you want to review what you've typed, or need to make corrections or revisions, use either the scroll bar or the cursor key to go back to the section you seek.

Section 9 - Readmission: complete this section only if you have previously attended Wittenberg

Months/Years of attendance:
From: To:

If you will have been absent for one full year or longer, list your principal activities, including education, since last attendance (include location and dates).
Occupation: Firm or School: Location: Dates (from-To):
Approximate number of Wittenberg credits earned:   

Section 10 - Disability Information

If you need disability-related accommodation to carry out your program, including the admission process, please use the box below for your explanation concerning the nature of your disability and the accommodation needed. If you require no accommodation but wish to make the University aware of a physical or mental disability, feel free to do so. If you choose to disclose a disability and request accommodation, the University may require additional supporting evidence before acting upon your application.

By submitting this application you have agreed to the following statement: To the best of my knowledge the information contained in this application is complete and accurate.

Wittenberg, a private university related to the Evangelical Lutheran Church in America, does not discriminate on the basis of gender, race, religion, color, creed, disability, sexual orientation, national origin, veteran status, ancestry, or age in the administration of educational policies and University-administered programs.