For questions, please e-mail rwoodus@towson.edu.

A. STUDENT STATUS

Please mark your status
Incoming freshman
Transfer student

B. PERSONAL INFORMATION

1. Last name First M.I.

2. Date of birth / /

3. TU Student ID (if applicable)
 
4. Gender* Male Female

5. Martial status* Married Single Divorced

6. Permanent address

7. Campus/Local address (if applicable)

8. E-mail address

9. Home phone On campus/local/cell phone

10. Where will you reside during the coming academic year?*
With parents/relatives On campus Off campus

11. Race/Ethnicity*
African American
Asian American
Caucasian
Hispanic American
Native American
Other

12. Citizenship*
United States Citizen
Permanent Resident
Student Visa
Other

13. Did your parents graduate from college?* Yes No
If yes, what institution?
Mother
Father

14. Do you reside in a single parent household?* Yes No

C. STUDENT DATA

1. When do you expect to graduate from TU?

2. FOR INCOMING FRESHMEN ONLY

Name of high school

Location of high school

High school GPA

SAT I scores: Math Verbal Written

Intended major at TU

3. FOR INCOMING TRANSFERS ONLY

Transferring from

Location

Degree completed

Major

GPA
  
4. FOR CONTINUING STUDENTS ONLY

Classification: Freshman Sophomore Junior Senior

Enrollment Status: Part time Full time

Year in School: 1st 2nd 3rd 4th 5th

GPA Expected date of graduation

Major Minor

Are you a degree seeking student? Yes No

D. EMPLOYMENT

1. Are you currently employed? Yes No
If yes, for how many hours per week?

2. Do you plan to work during the academic term you are seeking the CEEP Award? Yes No
If yes, for how many hours per week?

3. Where do you plan to work? On campus Off campus

E. FINANCIAL AID

1. What financial assistance (grants, scholarships, loans, etc.) do you expect to receive in the coming academic year?

F. COMMUNITY INVOLVEMENT

1. In what campus activities/organizations have you participated during this year?

2. In which of these organizations/activities have you held leadership positions? Please describe your duties.

G. PLANNED CEEP INVOLVEMENT

1. What activities will you select to enhance your multiracial, multicultural knowledge?

2. Name university sponsored organizations you want to join to fulfill the CEEP Award requirement.

H. ADDITIONAL INFORMATION

1. Are there factors in your social and/or academic backgrounds that could have interfered with your educational goals? Yes No
If yes, please explain fully.

2. Did you overcome personal, social and/or physical obstacles in order to pursue your education?
Yes No
If yes, please explain fully.

3. What other information do you want to mention or highlight as your application is considered for the CEEP Award?

I. CERTIFICATION

I certify that the information I have submitted on this application is accurate, true, and complete.
Name Date