Fillable Printable Minnesota State Colleges & Universities Application Form
Fillable Printable Minnesota State Colleges & Universities Application Form
Minnesota State Colleges & Universities Application Form
10/14
Minnesota State Colleges & Universities
Application for Admission
NOTE: We are asking you to provide information about yourself that is private under state and federal law. We are asking for this information in order to process your
application.
You are not legally required to provide the information requested, however, we may not be able to effectively process your application if you do not provide sufficient
information. With some exceptions, unless you consent to further release your private information, access to this information will be limited to system officials, who have
legitimate educational interests in the information. Under certain circumstances, federal and state laws authorize release of private information without your consent:
nto other schools in which you seek or intend to enroll, or are enrolled;
n to federal, state or local authorities for purposes of education program compliance, audit or evaluation;
n as appropriate in connection with your application for, or receipt of, financial aid;
n to your parents, if your parents claim you as a dependent student for tax purposes;
n if the information is sought with a subpoena, court order, or otherwise permitted by other state or federal law, and
n to an organization engaged in educational research or an accrediting agency.
Minnesota State Colleges and Universities abide by the provisions of Title IX and other federal and state laws forbidding discrimination on the basis of sex, race, color, national
origin or handicap and all other state and federal laws regarding equal opportunity. This document can be made available in alternate formats, such as large print or cassette tape,
upon request by calling one of the numbers above.
If you have been arrested, charged or convicted of any criminal offense, you should investigate the impact that the arrest, charge or conviction may have on your chances of
employment in the field you intend to study or on your chances to obtain federal, state, and other higher education financial aid.
The Minnesota State Colleges and Universities system is an equal opportunity employer and educator. This document is available in alternative formats to individuals with
disabilities, consumers with hearing or speech disabilities may contact us via their preferred Telecommunications Relay Service.
Directions: This application form may be used to apply to any of the 31 Minnesota State Colleges and Universities
including state universities, community colleges, technical colleges, and comprehensive community and technical
colleges. The system does not include the University of Minnesota.
All applicants must sign the application form in the box provided on page 4.
The high school preparation standards section on page 4 should be filled out by state university applicants only.
Please print or type. Complete the form accurately. Misrepresentation of application information
is sufficient grounds for canceling admission.
A one-time $20 non-refundable application/records fee must be included with your application to EACH institution.
(Some institutions may waive this fee in cases of extreme financial need. Fee waiver may be granted for eligible service members or
veterans. Contact the college’s or university’s Office of Admissions for more information about its policy.)
Use a separate form to apply for graduate school or international admission at state universities.
Call the Office of Admissions where you wish to attend to request the required form.
Submit this application to the college/university of your choice (see addresses on page 2).
Official high school and college transcripts must be submitted to the Office of Admissions of the
college or university you wish to attend.
If you have not already done so, you should apply for financial aid as soon as possible.
Many students who qualify for aid do not apply and do not receive funds that may be available for them. Even if you do not qualify for
grant aid, submitting a Free Application for Federal Student Aid (FAFSA) is required to be eligible for federally guaranteed loans. You
may fill out a FAFSA online by going to www.fafsa.ed.gov.
Visit www.mnscu.edu to search programs and explore colleges and universities,
or call 1-888-667-2848 for more information.
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MINNESOTA STATE
UNIVERSITIES
Page 2
Minnesota State Colleges & Universities
Bemidji State University*
1500 Birchmont Drive NE
Bemidji, MN 56601
1-877-236-4354
www.bemidjistate.edu
Metropolitan State University
700 Seventh St. E.
St. Paul, MN 55106-5000
(651) 793-1302
www.metrostate.edu
Minnesota State University,
Mankato
122 Taylor Center
Mankato, MN 56001
(507) 389-1822
1-800-722-0544
www.mnsu.edu
Minnesota State University
Moorhead
1104 Seventh Ave. S.
Moorhead, MN 56563
(218) 477-2161
1-800-593-7246
www.mnstate.edu
St. Cloud State University
720 Fourth Ave. S.
St. Cloud, MN 56301-4498
(320) 308-2244
1-877-654-7278
www.stcloudstate.edu
Southwest Minnesota State
University
1501 State St.
Marshall, MN 56258
(507) 537-6286
1-800-642-0684
www.smsu.edu
Winona State University
P.O. Box 5838
Winona, MN 55987
(507) 457-5100
1-800-342-5978
www.winona.edu
Anoka Technical College**
1355 W. Highway 10
Anoka, MN 55303
(763) 576-4850
www.anokatech.edu
Central Lakes College
Two campus locations
www.clcmn.edu
Brainerd campus
501 W. College Drive
Brainerd, MN 56401
(218) 855-8037
1-800-933-0346
Staples campus
1830 Airport Road
Staples, MN 56479
(218) 894-5100
1-800-247-6836
Century College
3300 Century Ave. N.
White Bear Lake, MN 55110
(651) 773-1700
1-800-228-1978
www.century.edu
Dakota County Technical College
1300 145th St. E.
Rosemount, MN 55068
(651) 423-8000
1-877-937-3282
www.dctc.edu
Fond du Lac Tribal
& Community College
2101 14th St.
Cloquet, MN 55720
(218) 879-0808
1-800-657-3712
www.fdltcc.edu
Hennepin Technical College
Two campus locations
(952) 995-1300
1-800-345-4655
www.hennepintech.edu
Brooklyn Park campus
9000 Brooklyn Blvd.
Brooklyn Park, MN 55445
Eden Prairie campus
13100 College View Drive
Eden Prairie, MN 55347
Inver Hills Community College
2500 E. 80th St.
Inver Grove Heights, MN 55076
(651) 450-3000
www.inverhills.edu
Lake Superior College
2101 Trinity Road
Duluth, MN 55811
(218) 733-7601
1-800-432-2884
www.lsc.edu
Minneapolis Community
& Technical College
1501 Hennepin Ave.
Minneapolis, MN 55403
(612) 659-6200
1-800-247-0911
www.minneapolis.edu
Minnesota State College -
Southeast Technical
Two campus locations
1-877-853-8324
www.southeastmn.edu
Red Wing campus
308 Pioneer Road
Red Wing, MN 55066
(651) 385-6300
Winona campus
1250 Homer Road
P.O. Box 409
Winona, MN 55987
(507) 453-2700
Minnesota State Community
& Technical College
Four campus locations
1-877-450-3322
www.minnesota.edu
Detroit Lakes campus
900 Highway 34 E.
Detroit Lakes, MN 56501
Fergus Falls campus
1414 College Way
Fergus Falls, MN 56537
Moorhead campus
1900 28th Ave. S.
Moorhead, MN 56560
Wadena campus
405 Colfax Ave. SW
Wadena, MN 56482-1447
Minnesota West Community
& Technical College
Five campus locations
www.mnwest.edu
Canby campus
1011 First St. W.
Canby, MN 56220
(507) 223-7252
1-800-658-2535
Granite Falls campus
1593 11th Ave.
Granite Falls, MN 56241
(320) 564-5000
Jackson campus
401 West St.
Jackson, MN 56143
(507) 847-7920
Pipestone campus
1314 N. Hiawatha Ave.
Pipestone, MN 56164
(507) 825-6800
1-800-658-2330
Worthington campus
1450 Collegeway
Worthington, MN 56187
(507) 372-3400
Normandale Community College
9700 France Ave. S.
Bloomington, MN 55431
(952) 358-8201
1-866-880-8740
www.normandale.edu
North Hennepin
Community College
7411 85th Ave. N.
Brooklyn Park, MN 55445-2299
(763) 424-0702
1-800-818-0395
www.nhcc.edu
Northeast Higher Education
District
Hibbing
Community College***
1515 E. 25th St.
Hibbing, MN 55746
(218) 262-7207
1-800-224-4422
www.hibbing.edu
Itasca Community College***
1851 E. Highway 169
Grand Rapids, MN 55744-3397
(218) 322-2340
1-800-996-6422
www.itascacc.edu
Mesabi Range College***
Two campus locations
(218) 749-0313
1-800-657-3860
www.mesabirange.edu
Eveleth campus
1100 Industrial Park Drive
Eveleth, MN 55734
Virginia campus
1001 W. Chestnut St.
Virginia, MN 55792
Rainy River
Community College***
1501 Highway 71
International Falls, MN 56649
(218) 285-7722
1-800-456-3996
www.rainyriver.edu
Vermilion
Community College***
1900 E. Camp St.
Ely, MN 55731
(218) 235-2191
1-800-657-3608
www.vcc.edu
Northland Community
& Technical College
Two campus locations
www.northlandcollege.edu
East Grand Forks campus
2022 Central Ave. NE
East Grand Forks, MN 56721
1-800-451-3441
Thief River Falls campus
1101 Highway 1 E.
Thief River Falls, MN 56701
1-800-959-6282
Northwest Technical College*
905 Grant Ave. SE
Bemidji, MN 56601
(218) 333-6645
1-800-942-8324
www.ntcmn.edu
Pine Technical &
Community College
900 Fourth St. SE
Pine City, MN 55063
(320) 629-5100
1-800-521-7463
www.pinetech.edu
Ridgewater College
Two campus locations
1-800-722-1151
www.ridgewater.edu
Hutchinson campus
2 Century Ave. SE
Hutchinson, MN 55350
(320) 234-8500
Willmar campus
2101 15th Ave. NW
PO Box 1097
Willmar, MN 56201
(320) 222-5200
Riverland Community College
Three campus locations
1-800-247-5039
www.riverland.edu
Albert Lea campus
2200 Riverland Drive
Albert Lea, MN 56007
(507) 379-3300
Austin campus
1900 Eighth Ave. NW
Austin, MN 55912
(507) 433-0600
Owatonna College
& University Center
965 Alexander Drive SW
Owatonna, MN 55060
(507) 455-5880
Rochester Community
& Technical College
851 30th Ave. SE
Rochester, MN 55904
(507) 285-7265
1-800-247-1296
www.rctc.edu
St. Cloud Technical
& Community College
1540 Northway Drive
St. Cloud, MN 56303
(320) 308-5089
1-800-222-1009
www.sctcc.edu
Saint Paul College
235 Marshall Ave.
St. Paul, MN 55102
(651) 846-1600
1-800-227-6029
www.saintpaul.edu
South Central College
Two campus locations
www.southcentral.edu
Faribault campus
1225 Third St. SW
Faribault, MN 55021
(507) 332-5800
1-800-422-0391
North Mankato campus
1920 Lee Blvd.
North Mankato, MN 56003
(507) 389-7200
1-800-722-9359
Alexandria Technical
& Community College
1601 Jefferson St.
Alexandria, MN 56308
(320) 762-4520
1-888-234-1222
www.alextech.edu
Anoka-Ramsey
Community College**
Two campus locations
(763) 433-1300
www.anokaramsey.edu
Cambridge campus
300 Spirit Drive S.
Cambridge, MN 55008
Coon Rapids campus
11200 Mississippi Blvd. NW
Coon Rapids, MN 55433
MINNESOTA STATE
COMMUNITY &
TECHNICAL
COLLEGES
* Bemidji State University and Northwest Technical College are aligned.
** Anoka-Ramsey Community College and Anoka Technical College are aligned.
*** The Northeast Higher Education District is a consortium of five state colleges: Hibbing, Itasca, Mesabi Range, Rainy River and Vermilion.
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Name (Last, First, Middle) Date of Application
Name used in high school records or in other educational records and transcripts, if different from above (Optional) (Last, First, Middle)
Social Security number Providing your Social Security number is voluntary. If you do not provide this number, your application will still be processed. Many colleges/universities use Social
Security numbers for student identification purposes on internal student records. The number may be used for purposes of administration, program evaluation,
___ ___ ___ – ___ ___ – ___ ___ ___ ___ consumer and alumni data, and also may be used to create summary information about system programs through data matches with other state agencies.
Current mailing address (House/Apartment Number, Street, P.O. Box/Rural Route) City State Zip Code County
Permanent address, if different from above (Street, P.O. Box/Rural Route) City State Zip Code County
Personal phone Work phone E-mail address
( ) ( )
Are you a resident of Minnesota? Yes No If yes, how long? ______years ______months If no, of which state are you a resident? __________________________
Are you a U.S. citizen? Yes No
If you answered no, do you have status as: Resident alien Refugee/asylee Temporary protected status None of these
If you answered none of these, do you have or intend to apply for a visa? Yes No
If you answered yes, you must contact the international student office at the college or university you wish to attend to determine whether a separate application is required.
Answer the following two questions only if you wish to qualify for in-state tuition and are NOT one of the following: a U.S. citizen; an international student maintaining valid
immigration status as a non immigrant; or a permanent resident, refugee or have been granted temporary protected status:
When you graduate from high school, will you have attended a high school in Minnesota for three or more years? Yes No
To qualify for resident tuition under the Prosperity Act, male students between the ages of 18 and 25 must have reigstered with the Selective Service System.
Please indicate one of the following: I have registered with Selective Service I have not registered with Selective Service I am not required to register for Selective Service
What is the highest level of education for your parent(s)/guardian(s)? Please respond for the parent(s), step-parent(s), adoptive parent(s) or guardian(s) who raised you.
Check only one box for each parent/guardian.
Parent/Guardian #1
No high school diploma High school diploma Some college Two-year college degree/diploma Bachelor’s degree or higher Not sure/don’t know
Parent/Guardian #2
No high school diploma High school diploma Some college Two-year college degree/diploma Bachelor’s degree or higher Not sure/don’t know
PERSONAL INFORMATION
ADMISSIONS INFORMATION
Name of Minnesota state college or university to which you are applying (use a separate copy of the application form for each institution)
Name of program, major or curriculum you plan to follow; e.g. English, electrical engineering, auto mechanics, nursing. Write “undecided” if you are, but indicate any alternatives you are considering.
(Check college/university policies for admission requirements to specific programs of study. List up to three.
What is your current educational intent at this institution?
Complete courses, but not a degree Earn associate (two-year) degree Earn associate (two-year) degree and transfer
Earn occupational certificate/diploma Complete courses and transfer without a degree Earn bachelor’s (four-year) degree
What term do you intend to begin taking courses? (Check only one and indicate the year)
Fall _____ Spring _____ Summer I _____ Summer II _____ Summer III _____
Do you plan to attend: Full time? (12 or more credits) Part time? (fewer than 12 credits)
Have you attended this college/university before? Yes No If yes, last date attended:________________________________________________________
Activities/interests: (optional) Please list _________________________________________________________________________________________________________________
Are you now serving, or have you ever served, in the United States armed forces? Yes No
Page 3
OFFICE USE ONLY
DATE RECEIVED DATE ACCEPTED APPLICATION FEE PAID
The following information will help Minnesota State Colleges and Universities evaluate student recruitment and retention policies; it will not be used as a basis for admission. Providing this information is
voluntary.
Gender Male Female
Are you Hispanic or Latino (a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture, regardless of race)? Yes No
Racial background (select one or more)
American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America) who maintains cultural identification
through tribal affiliation or community attachment.
Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian subcontinent.
Black or African American - A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White - A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
DEMOGRAPHIC INFORMATION
Application continues on next page
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n STATE UNIVERSITY APPLICANTS ONLY – PLEASE COMPLETE n
Students graduating from high school in 1994 or later must meet preparation requirements for admission/transfer to Minnesota state
universities. Please list coursework that will be completed by graduation from high school.
HIGH SCHOOL PREPARATION STANDARDS FOR MINNESOTA’S STATE UNIVERSITIES
Page 4
SIGNATURE REQUIRED BY ALL APPLICANTS
All of the information included is true and complete to the best of my knowledge.
Applicant’s signature Date
Do you have a high school diploma? Yes No High school graduation date: _________________________________________________________
If no, do you have a GED? Yes No Are you currently in high school? Yes No
High school attended City State Zip
List any other post-secondary institutions attended Official transcripts from each institution attended must be sent directly to the Admissions Office of the college/university.
College/University/Institution City State Dates of attendance Degrees earned
College/University/Institution City State Dates of attendance Degrees earned
College/University/Institution City State Dates of attendance Degrees earned
Are you a high school student planning to take college courses under the Minnesota Post-Secondary Enrollment Options program (PSEO)? Yes No
If yes, please contact your high school counselor and also the admissions office of the college/university you plan to attend.
EDUCATIONAL INFORMATION
Number of Years (or fraction thereof):
ENGLISH
(Minimum of 4 years, including composition, literature and speech)
English Total_______Years
MATHEMATICS
(Minimum of 3 years, including 2 years of algebra, one of
which is intermediate or advanced, and 1 year of geometry)
Elementary algebra _______Years
Intermediate algebra _______Years
Advanced algebra _______Years
Geometry _______Years
Trigonometry _______Years
Pre-calculus _______Years
Other _______Years
Mathematics Total _______Years
SCIENCES
(Minimum of 3 years, including at least 1 year each of a biological and physical science with
significant laboratory experience in all courses)
Biological science with lab _______Years
Physical sciences with lab _______Years
Physics with lab _______Years
Chemistry with lab _______Years
Other with lab _______Years
Science Total _______Years
Number of Years (or fraction thereof):
SOCIAL STUDIES
(Minimum of 3 years, including 1 year each of geography and U.S. history)
U.S. history _______Years
Geography _______Years
Other _______Years
Social Studies Total _______Years
WORLD LANGUAGE (Specify) __________________________________________
(Minimum of 2 years of a single world language, including non-English native languages and
American Sign Language)
World Language Total _______Years
ELECTIVES
(Minimum of 1 year of either visual or performing arts)
Visual arts _______Years
Music _______Years
Theater/Drama _______Years
Dance _______Years
Media arts _______Years
Electives Total _______Years
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HIGH SCHOOL/GED TRANSCRIPT RELEASE PERMISSION
Note to applicant:
Tear off, sign and send or give directly to the last high school attended. Your transcript
cannot be sent without signed permission.
I, __________________________________________________________________________________________________
hereby request ___________________________________________________________________________
to send a high school transcript, GED record, and/or IEP to:
Name of college/university and campus
Address
City State Zip Code
Applicant’s signature Date
Transcript Information:
Name used on school transcript
Year graduated or last attended
Date of birth Social Security number
This information will be used only to
verify the correct identity of the student
Parent’s signature (if under 18) Date
Note to school personnel: Send all transcripts and/or IEPs directly to the college/university
indicated by the applicant. Please copy this release and return it with the transcript.
Keep the original release for your records.
(Last high school attended - include city and state)
(Student name)
