NKU School-Based Scholar (SBS) Application Form

* required field

Your Information

First Name

Middle Name

Last Name

Preferred First Name

Suffix

Birthdate

Legal Sex

Social Security Number | Privacy Protection Policy
(Please enter only 9 numeric values, no dashes)

Country of Citizenship

Are you a permanent resident of the United States?

Yes

Your Contact Information

Email Address

Mobile Phone

Mailing Address

Same as Permanent Address

Country

Street

City

Region

Postal Code

Permanent Address

Same as Mailing Address

Country

Street

City

Region

Postal Code

Academic Information

High School Name
(Begin typing and choose your school from the list)

Are you attending Ignite Institute?

Current Grade

Self-Reported GPA

Self-Reported GPA
(If applicable)

Copy of High School Transcript

(If applicable)

ACT Score

(If applicable)

Entry Term

Sub-session

Parent/Guardian Information

Primary Parent/Guardian Relationship

Primary Parent/Guardian First Name

Primary Parent/Guardian Last Name

Primary Parent/Guardian Email Address

Primary Parent/Guardian Mobile Phone Number

Has this Parent/Guardian completed a bachelor’s degree or higher?

Is this Parent/Guardian a graduate of NKU?

Disclosure Form

In order for your application to be reviewed, you and a parent or guardian must review and sign the disclosure form in ink. Please download the form to upload with your application.

Add Secondary Parent/Guardian

Secondary Parent/Guardian Relationship

Secondary Parent/Guardian First Name

Secondary Parent/Guardian Last Name

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Mobile Phone Number

Has this Parent/Guardian completed a bachelor’s degree or higher?

Is this Parent/Guardian a graduate of NKU?

Background Information

Have you ever been found responsible for a student disciplinary violation at any higher education institution (college or university)?

Have you ever been adjudicated guilty or convicted of a felony, or do you have open cases involving felony accusations that have yet to be resolved? (Note that you are not required to answer "yes" to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise required by law or ordered by a court to be kept confidential).

The Office of Admissions is charged with admitting students to the University. Of paramount concern to the University as a whole is the health, welfare, and safety of our students, and the protection and preservation of their property. As a component of such, the Admissions Application will inquire as to the existence and nature of disciplinary history and/or criminal background. This policy shall apply, without limitation, to any individual requesting admission to the University. All applicants and former applicants are required to report such information in order to have their application considered complete, and in order to determine their eligibility to be admitted to Northern Kentucky University.

By submitting this application for admission:

I certify that the information provided here is complete and correct, and I understand that the submission of false information is grounds for denial of my application, withdrawal of any offer of acceptance, cancellation of enrollment, or any appropriate disciplinary action.
I authorize the University to verify the information I have provided with all the schools I have attended.
I agree to notify the proper officials of the institution of any changes in the information provided.
I give my high school permission to send my official transcript directly to Northern Kentucky University.
I understand that withholding information on this application or giving false information will make me ineligible for admission. If discovered after enrollment, there is the possibility of suspension and/or expulsion from the university and/or billing for financial restitution due to the providing of false information. With this in mind, I certify that the above statements are correct and complete.
If you are a citizen of the European Union, by completing and submitting this application you consent to NKU using the information you provide for admission related decisions.

Northern Kentucky University shall provide equal opportunity in all aspects of education and activities without regard to race, color, sex, religion, national origin, age, disability, or veteran status. NKU is handicapped accessible and is an equal opportunity/affirmative action institution

Federal legislation requires institutions of higher education to inform prospective members of our community about its most recent crime/incident statistics; crime prevention; security programs and activities; policies concerning the reporting of crime; and related information in accordance with the Campus Security Act, commonly referred to as the Clery Act. Upon request, you can obtain a paper copy of the university’s Annual Campus Security Reports by contacting the NKU Police Department, 419 Old Johns Hill Road, Highland Heights, KY 41099 or calling 859-572-5746. This information is also available on the NKU Police Department’s website at http://police.nku.edu/JeanneCleryAct/securityreports.html.

In place of your signature, please type your full legal name