Full Legal Name (required)

Permanent Address (required)

City (required)

State (required)

Zip Code (required)

Home Phone Number

Mobile Phone Number

Work Phone Number

Email (required)

As prescribed by the Department of Education and the National Center for Education Statistics, we are required to ask for demographic information including racial background. This information is not used in the admission process. Using the terminology of the NCES, please answer each of the following:

Select Race/Ethnicity:
Please SelectHispanic or LatinoAmerican Indian or Alaskan NativeAsianAfrican AmericanHawaiian or Pacific IslanderWhite or Caucasian

Are you a U.S. Citizen?
YesNo

If no, are you a..
Please SelectPermanent ResidentResident AlienNon-resident Alien

Gender
Please SelectMaleFemale

Date of Birth

Place of Birth

Graduate of High School:

High School GPA:

Class Rank:

High School Address:

When will (or did) you graduate?

High School Type
Please SelectPublicPrivatePrivate Cristian High SchoolHome School

High School Guidance Counselor

Counselor's Phone Number

If you did not graduate from high school, do you have a General Education Diploma (GED)?
Please SelectYesNo

Home Church

Church Address

Church City/State/Zip

Denominational Affiliation

Church Phone Number

Pastor/Minister

List all colleges previously attended , including dual enrollment programs. Even if you withdrew prior to earning credits, you must have official transcripts sent from each institution.

Are you currently enrolled in high school or college?
NoYes

Classification
Please SelectFRSOJRSRDual-Enrollment

If not currently in high school or college, what is your current status or occupation?

When Do You Plan To Enter JWC?
Please SelectSpring SemesterSummer SemesterFall SemesterUndecided

Enrollment Status:
Please SelectFreshman ApplicantTransfer Applicant

HOUSING: (Mark Each Of The Following)

Do you plan to live at home?
NoYes

Do you need housing?
NoYes

INTENDED PROGRAM:

DIPLOMA IN
Humanities (DH)Christian Ministry (DCM)

ASSOCIATE OF ARTS IN
Humanities (AAH)Christian Studies (AACS)

BACHELOR OF ARTS IN
Humanities (BAH)Christian Studies (BACS)

Vocational Objective

COLLEGE ENTRANCE TEST (Entrance exams are not required if over age 22.)

ACT Composite

SAT (Critical Reading)

SAT (Math)

CLT Composite

If entrance tests have not been completed, list the date you plan on taking the exams:

At any time, have you been charged, arrested, or convicted of a criminal offense of any nature?
NoYes

Transfer Applicants only – have you ever received official disciplinary action at a college in which you were enrolled?
NoYes

If you answered yes to either of the above, please provide details of each occurrence.

Transfer Applicants only – are you eligible to re-enroll at the last institution you attended?
NoYes

If you answered no, please explain:

To what other colleges have you applied?

FAMILY INFORMATION

Parent/Guardian Name(s)

Parent/Guardian Address

Parent/Guardian City

Parent/Guardian State

Parent/Guardian Zip Code

Parent/Guardian Email Address

Parent/Guardian Primary Phone Number

Spouse’s Name (if married)

Spouse’s Email Address

Spouse’s Primary Phone Number

By submitting this application online, you have initiated the John Witherspoon
College admissions process. Additional materials as noted in the CHECKLIST BELOW are
required to complete your application file.

CHECKLIST: The following will be needed to complete your application file:
□ COMPLETED APPLICATION FORM
□ PERSONAL ESSAY
□ PASTORAL EVALUATION (SEPARATE FORM)
□ PERSONAL INTERVIEW
□ TRANSCRIPTS – OR OTHER PROOF OF COMPLETION OF SECONDARY EDUCATION
□ ACADEMIC EVALUATION (SEPARATE FORM)
□ SIGNATURE

Please sign your name below to authorize that the above information is accurate to submit for your online application to John Witherspoon College.

What is the capital of South Dakota?