MORE+ experience APPLICATION FOR - Indiana University Kokomo
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APPLICATION FOR
2021-2022INDIANA UNIVERSITY KOKOMO
ADMISSIONS STANDARDS
Thank you for applying to Indiana University Kokomo. In order to ensure that admitted students are prepared to be successful, each
candidate for admission is considered on an individual basis. Completed applications should be submitted at least two weeks prior to
the start of the term.
Please refer to the admissions status options below. You will select one when completing the application.
FIRST YEAR APPLICANT UNDERGRADUATE NON-DEGREE
If you have not attended another college or university after APPLICANT
completing high school or earning a GED, you must submit the If you have earned a high school diploma, GED or some college
following materials: credits and do not plan to seek a degree at this time, you must
submit the following materials:
+ Application for Undergraduate Admission
+ Application for Undergraduate Admission
+ Official high school transcript or GED scores
+ If you have no college experience, submit official high school
+ Test scores are optional for admission but required for transcript or GED scores
scholarship consideration. + If you have earned any college-level credit hours, submit a
+ If you earned college credit while in high school, please submit transcript from the last college or university attended
an official transcript from each college or university attended + Financial aid is not available
+ $35 non-refundable application fee GRADUATE NON-DEGREE APPLICANT
TRANSFER APPLICANT If you have previously earned a bachelor’s degree and do not
wish to seek a degree at this time, you must submit the following
If you have attempted or earned 12 college credits at another college materials:
or university, you must submit the following materials:
+ Application for Undergraduate Admission
+ Application for Undergraduate Admission + Official transcript showing the undergraduate degree you
+ Official transcript from each college or university attended were awarded
+ Financial aid is not available
+ Official high school transcript or GED scores if you have earned
less than 12 college level credit hours SPECIAL HIGH SCHOOL APPLICANT
+ $35 non-refundable application fee If you have completed your junior year of high school and wish
to enroll in a course on campus, you must submit the following
VISITING/GUEST STUDENT APPLICANT materials:
If you are attending another college or university and wish to attend + Application for Undergraduate Admission
IU Kokomo for one semester or summer session and return to your + Official high school transcript showing coursework
home institution, you must submit the following materials:
+ A copy of your PSAT, SAT or ACT scores
+ Application for Undergraduate Admission + Letter of recommendation from your guidance counselor
+ Transcript from your home institution showing grades from + Financial Aid is not available
your most recent semester
NON-U.S. CITIZENS IN THE U.S.
SECOND DEGREE APPLICANT If you are in the U.S. on a Visa, please contact the Office of
If you have earned a bachelor’s degree and wish to earn another Admissions for more information. If you are a permanent
resident, refugee, or political asylee, complete this application.
bachelor’s degree, you must submit the following materials:
+ Application for Undergraduate Admission
+ Official transcript from each college or university attended
+ $35 non-refundable application fee if not paid previously at
IU KokomoETHNIC INFORMATION POLICY
Ethnic information is gathered in compliance with Title VI of the Civil Rights Act of 1964 and Title IX of the Education
Amendments of 1972 and is requested by the U.S. Department of Education. You may choose not to answer this question
on the application; responding will not affect the admission decision in any way.
SOCIAL SECURITY NUMBER
In accordance with state and federal law, the disclosure of your Social Security number is voluntary. However, you will
be required to use your Social Security number if you receive any form of federal financial aid.
PAYMENT DISCLOSURE
By sending a check for payment, you are authorizing Indiana University to use information from your check to make a
one-time electronic debit from your account at the financial institution indicated on your check. This electronic debit
will be for the amount of the check and will post to your bank account within one day of receipt by us. The canceled
check will not be returned with your checking account statement. If we cannot post the transaction electronically, you
authorize us to present an image copy of your check for payment. You agree that if a third party submits a check on
your behalf, that individual is your agent and was provided with these disclosures. Please contact 765-455-9352 to learn
about other payment options if you prefer not to have your check used in this way.
SPECIAL NEEDS
If you are physically challenged or hearing, learning, or visually impaired and wish to receive information regarding
accessibility services, contact the Accessibility Center at 765-455-9301.
Indiana University is an Affirmative Action/Equal Opportunity institution. Individuals needing this information in an
alternative format should contact the Office of Affirmative Action at 765-455-9529.
ANNUAL SECURITY REPORT IS AVAILABLE
Indiana University Kokomo is committed to assisting all members of the IU Kokomo community in providing for
their own safety and security. The annual security compliance document is available on the IUPD-KO website
at iuk.edu/clery. If you would like to receive a hard copy of the Annual Security Report which contains this
information, you can visit IU Kokomo Police in Kelley Student Center, Room 240 or you can request that a copy
be mailed to you by calling 765-455-9432.
CHOOSE YOUR MAJOR: (Please choose one from the list on the next page.)
* All Pre-Professional Programs require that students transfer to Students will be guided to select a major from the list of
another institution or IU campus to complete their degree. baccalaureate degrees and work with an academic advisor to
plan an appropriate course of study.
**After completing program prerequisites, a separate application
Please note: not all certificate programs qualify for financial aid.
is required for admission into this major.BACHELO R’S D EGREES
Applied Science Hospitality and Tourism + Science
+ Healthcare Management Humanities + Social Studies
+ Sustainability Studies + Performing Arts Sociology
+ Individualized Track + Fine Arts + Applied Sociology
Biochemistry Informatics + Children and Families
Biological and Physical Sciences Mathematics + Crime and Society
+ Earth and **Medical Imaging Technology + Human Services
Sustainability Sciences + Sonography (Ultrasound) + Medical Sociology
+ General Science + Computed Tomography (C.T.) Sport & Recreation Management
Biology + Magnetic Resonance
Business Imaging (M.R.I.) ASSOCI ATE
+ Accounting + Echocardiography DEGR EES
+ Finance and Economics + Mammography / Breast **Radiography
+ Human Resources Sonography (Ultrasound)
*UNDERGRADUAT E
+ Management + Picture Archiving and
Communication / PROGRAMS
+ Marketing (start your journey here and finish
Dept. Management
Chemical Biology at another campus)
+ Vascular Sonography
Chemistry *Clinical Laboratory Science
New Media, Art & Technology
Communication *Cytotechnology
+ Creative Digital Development
+ Public Communication *Dental Hygiene
+ Graphic Design
+ Journalism *Nuclear Medicine Technology
+ Studio Art
+ Public Relations / *Paramedic Science
+ Web Design
Corporate Communication *Radiation Therapy
** Nursing
Computer Science *Respiratory Therapy
+ Pre-Licensure
Criminal Justice
+ R.N. to B.S.N.
**Elementary Education UNDERGRA DUAT E
+ 2nd Degree B.S.N.
English CERTI F I CATES
*Pre-Professional
+ Literature and Languages
+ Pre-Chiropractic Coding Technology
+ Writing, Editing,
+ Pre-Medical Contemporary Entrepreneurship
and Media
+ Pre-Occupational Therapy Homeland Security /
General Studies
Emergency Management
+ Arts and Humanities + Pre-Optometry
Spanish
+ Interdisciplinary + Pre-Physical Therapy
+ Science and Mathematics + Pre-Veterinary
POST
+ Social and Psychology BACCALAUR E AT E
Behavioral Sciences Public Administration CERTI F I CATES :
Health Sciences + Health Administration Accounting
+ Exercise and + Public Management Business Fundamentals
Sport Science
**Secondary Education Informatics
+ Health Promotion
+ Fine / Visual Arts Mathematics
+ Nutrition
+ Language Arts New Media, Art & Technology
History & Political Science
+ Mathematics
+ Pre-Law
SO ME OF OUR UND ERGRADUATE AND GRADUAT E
P ROG RA MS ARE OFFERED 100% ONLI NE
GET M OR E DE TA I LS FO R O N L I N E P RO G RAM S AT academics.iuk.eduINDIANA UNIVERSITY KOKOMO Office of Admissions
Kelley Student Center, Room 230
Applica n for Admission (765)455-9271 or toll free (888)875-4IUK
Apply online: apply.iu.edu iuk.edu/admissions iuadmis@iuk.edu
PERSONAL INFORMATION
1)*Legal Name (required):
Legal First Name Legal Middle Name Legal Last Name
2) Former/Maiden Names
(required – list all former names):
First Name Middle Name Last Name
3) Preferred Name:
4) Social Security Number : ____________-__________-____________ 5)*Date of Birth (required): ___________________________________
(op onal, but required for financial aid)
MM/DD/YYYY
6)*What is your legal sex (required)? Male Female 7) Gender Iden ty: _______________________
8)*Home Address (required):
Number and street City State Zip County (Example: Adams)
9)*How long have you lived at your home address (required)? Less than twelve months Twelve months or more
10)*If less than twelve months, list dates and addresses for the past two years (required; include a separate sheet if necessary):
Number and street City State Zip County (Example: Adams) From: MM/YYYY To: MM/YYYY
Number and street City Zip County (Example: Adams) From: MM/YYYY To: MM/YYYY
State
11)*Mailing Address (required):
Same as home address Number and street City State Zip County (Example: Adams)
12) Home Phone: (______)________-___________ Preferred 13) Cellular Phone: (______)________-___________ Preferred
14) Would you like to receive text messages about your applica on to Indiana University and other important informa on related to the admissions process? Add onally,
if you choose to a end Indiana University, we will also send you text messages about upcoming deadlines and other important informa on related to your enrollment. Text
and data rates may apply.
Yes, IU may text me. No, do not text me.
15) Email Address:__________________________________ 16) TWITTER: Please provide your Tw er username if you would like to receive tweets
concerning your admission decision, events, etc._______________________________________
CITIZENSHIP and ETHNICITY
17)*What is your ci zenship status (required)? U.S. C en Refugee Asylee
Permanent Resident DACA Other: ______________________________
18) If you are not a U.S. ci zen, please list your country of ci zenship:________________________________________
19) Are you Hispanic or La no? Yes No
20) With which of the following racial categories do you iden fy (select one or more)?
American Indian or Alaskan Na ve Asian Black or African American Na ve Hawaiian or Other Pacific Islander White
21) What is your na ve language? ______________________ 22) Did either parent/guardian a end college? Yes No
23) Have you previously or are you currently serving in the U.S. 24) Have you received an honorable discharge from the U.S.
Armed Services? Armed Services?
Yes No Yes No Not yet discharged
"ENROLLMENT GOALS
25)*When do you wish to enroll (required-select one)? Fall (August) Spring (January) Summer I (May) Summer II (July) Year: ____________
26)*Intended Degree (required): Bachelor’s Degree (4 Years) Associate Degree (2 Years) Cer ficate Program
Visi ng/Guest Student High School/Dual Enrollment
27) Please list your intended academic Major (list only one): _________________________________________________________
PARENT/GUARDIAN INFORMATION (Required: Applicants 21 and under provide parent(s) or guardian(s) informa on)
28) Parent/Guardian #1 name: 29) What is their rela onship to you?
(Parent, grandparent, stepparent, etc.) _______________________________________
First Middle Last
30) Address: 31) Email address?________________________________
Number and street City State Zip
32) How long at this address?_______________________
33) Parent/Guardian #2 name: 34) What is their rela onship to you?
(Parent, grandparent, stepparent, etc.) _______________________________________
First Middle Last
35) Address: 36) Email address?_______________________________
Number and street City State Zip 37) How long at this address?______________________
EDUCATIONAL HISTORY
38)*Gradua ng high school (required):
School Name City State From: MM/YYYY To: MM/YYYY Gradua on Date: MM/YYYY
39) Which diploma type will you earn upon gradua on (Indiana applicants only)?
Core 40 Academic Honors Technical Honors Academic Honors and Technical Honors Not Applicable (non-Indiana applicants)
40)*List any other high schools you have a ended. Include a separate sheet if necessary (required):
From: MM/YYYY To: MM/YYYY Gradua on Date: MM/YYYY
School Name City State
City State From: MM/YYYY To: MM/YYYY Gradua on Date: MM/YYYY
School Name
From: MM/YYYY To: MM/YYYY Gradua on Date: MM/YYYY
School Name City State
41)*Did you complete a GED or high school equivalency (required)? Yes No 42)*In which state was it completed (required)? __________
43)*Did you a end college classes before gradua ng from high school (required)? Yes No Number of credits earned:___________
44)*Did you a end college classes a er gradua ng from high school (required)? Yes No Number of credits earned:___________
45)*List all previous colleges and universi es you have a ended (including other IU campuses). Include a separate sheet if necessary (required):
*Veterans may receive credit for their military service experience. Student should submit an official copy of their Joint Service Transcript (JST) if applicable.*
School Name City State A nded From: MM/YYYY To: MM/YYYY Degree Earned
School Name City State A nded From: MM/YYYY To: MM/YYYY Degree Earned
School Name City State A nded From: MM/YYYY To: MM/YYYY Degree Earned
"TEST RESULTS (Required for Freshman applicants)
46) I want my ACT/SAT scores included in the review of my applica on. 47) Do not include my ACT/SAT scores in the review of my applica on.
Self-Reported Test Results
IU campuses statewide now accept self-reported SAT/ACT scores for admissions purposes. If you would like to provide self-reported test scores you may enter them below.
Please note that once adm ed, students are required to submit test scores either directly from the tes ng agencies or they may be included on your high school transcript.
48) If you would like to provide self-reported ACT test scores you must include 49) If you would like to provide self-reported SAT test scores you must include scores
scores for all test subjects. Please report your highest score for each sec on. for all test subjects. Please report your highest score for each sec on.
You must also include the test date. You must also include the test date.
ACT Scores and Test Dates SAT Scores and Test Dates
Composite:_________________ Test Date (MM/DD/YY):______________ English/Wr ng Subsec on:________ Test Date (MM/DD/YY):______________
English:_____________________ Test Date (MM/DD/YY):______________ Mathema cs Subsec on:__________ Test Date (MM/DD/YY):______________
Mathema cs:________________ Test Date (MM/DD/YY):______________
Reading:____________________ Test Date (MM/DD/YY):______________
Scien c Reasoning:__________ Test Date (MM/DD/YY):______________
CRIMINAL ACTIVITY/DISCIPLINARY INFORMATION (Applicants must answer each ques on)
We are commi ed to maintaining a safe learning environment. As part of that commitment, Indiana University requires applicants to disclose if they a) have been subject
to formal disciplinary ac on (including for example, but not limited to, suspension or expulsion) for academic or non-academic reasons at any high school, post-secondary
ins tu on, college or university; b) have been charged with or convicted of a crime (or a foreign legal equivalent) that has not been expunged by a court; and/or c) have
engaged in behavior that causes injury to person(s) or personal property (including for example, but not limited to, vandalism or behavior that led to a restraining order
against you) which resulted in some form of discipline or interven on.
A previous disciplinary , charge, convic , or conduct of the sort i fied here does not ally disqualify applicants from admission, but they do
require review by the campus admissions Furthermore, the review of any behavior disclosure information provided will be conducted independently of
the evaluation of your academic eligibility for admissions and will only be shared with the admissions committee and/or with other officials at IU who have a
need to know as part of the behavior review process.
PLEASE NOTE: By submi ng your applica on to Indiana University, you acknowledge and agree that you have a con nuing obliga on to inform the University of any formal
disciplinary ac on for academic or non-academic reasons at any educa onal ins tu on; any legal charges and/or convic ons (or the foreign equivalents) that have not
been expunged by a court; and/or any behavior that causes injury to person(s) or property which results in some form of discipline or interven on. You must provide
updated informa on to the campus admissions commi ee prior to class registra on or class a endance, whichever is applicable. At that me, the campus admissions
commi ee will review the informa on provided and may consider whether to delay or rescind your admissions.
If you answer yes to any of the ques ons below, you must provide a complete explana on and a ach any relevant documenta on.
50) Have you been subject to formal disciplinary ac on or diversion program (including for example, but not limited to, suspension or expulsion) for
academic or non-academic reasons at any high school, post-secondary ins tu on, college or university (required)? Yes No
51)*Have you ever been arrested or convicted of a crime (or a foreign legal equivalent) that has not been expunged by a court? Yes No
*Also select “Yes” if you have currently pending criminal charges (or the foreign legal equivalent) against you (required).
Affirma on Statement
I understand that withholding per nent informa on requested on this applica on or giving false informa on on this applica on will make me ineligible for admission or will
make me subject to cancella on of admission if admission has already been granted or dismissal if already enrolled. I cer fy that all statements on this applica on are
correct and complete, including a report of possible college credit and criminal or disciplinary history as described in the instruc ons on the applica on for admissions. I
understand that providing false informa on could also impact the classifica on of tui on residency status for fee-paying purposes and scholarship eligibility. I give my
permission to officials at all ins u ons I have a ended to release informa on needed by the university to substan ate s tatements I have made on this applica on. I grant
Indiana University permission to inves gate my criminal or educa onal disciplinary background if necessary. I understand that all official documents subm ed with the
applica on remain the property of Indiana University and will not be returned or forwarded to another college or university.
___________________________________________________ ______________________
*Signature (required) *Date (required)
"
For Office Use Only
Applica on Fee: Amount Paid_____________ Payment Method: Cash Check (check #_________) Credit Card WaivedYOUR IU DEGREE
CLOSE TO HOME
iuk.edu
f t i s
2300 South Washington Street
P.O. Box 9003
Kokomo, IN 46904-9003
765-455-9217 or 888-875-4IUK
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