First Name

Middle Name

Last Name

Chosen Name

Former last name (if applicable)

Email

Do you currently live outside of the United States?

May we contact you via text message?

How did you hear about us?

Legal Sex

Gender Identity

Pronouns

Are you seeking a degree from SUNY SULLIVAN?

Permanent Address Line 1 Include Apt #

Permanent Address Line 2

Permanent Address City

Permanent Address state

Permanent County of Residence

Diversity Statement

SUNY Sullivan values diversity. The viewpoints, identities, and histories that our students, faculty, and staff bring enhance our commitment to diversity, equity, and inclusion. Our founding principles and support for undocumented students guides our actions. You can go to college. Currently, there is no federal law preventing you from attending. SUNY Sullivan does not, and will not,  consider national origin or immigration status as a factor in admission. We encourage all students, regardless of citizenship status or national origin, to apply for admission, including undocumented and Deferred Action for Childhood Arrivals (DACA) students graduating from U.S. high schools (adapted from https://www.suny.edu/attend/get-started/undocumented/).

Citizenship status

Citizenship

If you are not a United States citizen, and you are  living in the United States on a Visa, what type of Visa is it?

Ethnicity
Note: Select "Hispanic or Latino" if you are a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

Race
Note: Mark one or more races to indicate what the candidate considers himself/herself to be.

What is your Ancestry?  Select all that apply.

What is the primary language used in your home?

Are you expecting to graduate High School, or have you graduated High School

High School Attended

High School City

High School State

High School Graduation Date

Do you have a GED?

Have you ever applied/attended SUNY Sullivan?

Last College/University Attended  (if applicable)

Which year and term do you plan to attend

Program of interest -- major

Enrollment Status

EOP

EOP is designed to help students who have been historically disadvantaged academically and economically to reach their full potential. Please click yes if you're interested in applying for the Educational Opportunity Program?  For more information visit https://www.suny.edu/attend/academics/eop/

If you received a letter from SUNY recently, please enter the offer code provided. 

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