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Home > Admissions > Quick Admission

Application for Non-Matriculated Admission

Please complete all appropriate fields on this form.

For Entry:	Summer Fall Winter Spring
SSN:
Date of Birth:
First Name:
Last Name:
Middle Initial:
Address:
Apt:
City:
State:
Zip:
County:
Phone:
Gender:	Male Female
Email Address:
Are you a US citizen?:	Yes No
If No,are you a permanent resident?	Yes No
Alien Registration: A#
Are you a veteran?	Yes No
Have you been convicted of a felony?	Yes No
Ethnicity:	Hispanic/Latino American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
If Hispanic/Latino, is your background:	Central American Dominican Mexican Puerto Rican South American Other
Highest Degree Earned:	H.S. Diploma GED Associates Bachelors Masters Doctorate
Institution Degree is From:
Status:	Full Time Part Time
Most Recent School/College/University:

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SUNY College at Old Westbury, P.O. Box 210, Old Westbury, NY 11568-0210 - (516) 876-3000
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