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Supplement to the Common Application

Please fill out the following online supplement form or download the PDF version.

 

Personal information

Your legal name (enter name exactly as it appears on your passport or other official documents):

Last:
First:
Middle(complete):
Jr.(etc):
Gender:

 

Permanent home address:

Number and street
City/Town
State/Province
Zip code/postal code
Country

 

Academic information

I am applying to Augustana Collge as a (check all that apply):

first year student transfer student full-time student part-time student
degree-seeking student non-degree-seeking student

 

I am applying for the term beginning
fall winter spring     Year

 

I will live on campus commute from home

 

I also have applied or plan to apply to the following college/s

 

I would like to be considered for enrollment in Augustana's Honor Program:
Yes No

For information on the Honors Program call the Office of Admissions at 1(800)798-8100. 

 

Financial assistance information

Are you the beneficiary of a 529 pre-paid tuition plan? Yes No

 

Family Information

List any relatives who have attened Augustana
(if applicable, please include maiden names):

NAMERELATIONSHIP TO YOUDATES AT AUGUSTANA COLLEGE

 

List all members of your family (besides yourself) currently in high school:

NAMEHIGH SCHOOLEXPECTED YEAR OF GRADUATIONMAY WE CONTACT?
yes no
yes no
yes no

 

Supplemental information

The following persons/items influenced me to apply to Augustana College* (check all that apply):

relative counselor teacher coach Augustana alumna/alumnus
current student brochure or other mailing visit to campus
Other (please explain):

*Please list their names

 

I have visited Augustana's campus during the following events

personal admissions interview/date
visit day/date
athletic visit/date
visit to friends in college/date
other/date

 

I have friends and/or teachers who attended or who now attend Augustana College. (If teachers, please also indicate subject taught):

NAMERELATIONSHIP/SUBJECTCLASS YEAR

 

Optional Information

Religious affiliation:

Baptist Catholic Episcopalian Jewish Lutheran Methodist Muslim
Presbyterian United Church of Christ Other: