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State University College at Oneonta

 

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Prospect Information Form

  

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Information Please enter the requested information. Please note that an asterisk denotes required information.

Required - indicates a required field.
Prospect Name
Prefix:
First Name: Required
Middle Name:
Last Name: Required
Suffix:
Nickname:

Primary Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number:Required - (xxx)-(xxxxxxx) (xxxx extension) Right ArrowPhone number is required
International Access Code:

E-Mail Address
E-mail Address:
Verify E-mail Address:

Information Enter the semester you plan to enroll in SUNY Oneonta.

Prospect Entry Term
Term of Entry:

Prospect Student Type
Student Type:

Information Click the Look Up College Code button to find your Prior College Code.

Prospect Prior College
College Code:
Prior College Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Attended From:
Attended To:
Graduation Date: Month Day Year (YYYY)
GPA: (example: 9.99)
Degree:

Information Enter your test scores below.

Prospect Test Scores
Test Type: Test Score: Test Date:
Month Year (YYYY)  
Month Year (YYYY)  
Month Year (YYYY)  

Information If you choose to complete the following, the information will be used for research and governmental reporting only.

Prospect Ethnicity/Race
Ethnicity:

Note What is your ethnicity?

Hispanic or Latino
Not Hispanic or Latino

Note Select one or more races to indicate what you consider yourself to be.

American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian and Other Pacific Islander
Other
Unreported
White

Prospect Birthdate
Date of Birth: Month Day Year (YYYY)

Prospect Gender
Gender: Male Female Not Specified

Information Your Social Secruity Number is confidential and used only for internal identification.

Prospect SSN/TIN/TFN
U.S. Social Security Number: (999999999 or 999-99-9999)

Information You may select up to five interests. To select multiple interests use CTRL+Click for PC and Command+Click for Mac.

Prospect Interests
Interests:

Information Select the materials you would like for the program interests selected above. To select multiple materials use CTRL+Click for PC and Command+Click for Mac.

Requested Material
Request Materials:



For Office UseOnly:
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