Lebanon Campus First Year Application

After completing the application for admission, please forward all supporting documents to the Office of Admission at 701 College Road, Lebanon, IL 62254.

    

Personal Information
 
First Name    Middle Name    Last Name    Suffix
     

 
Preferred First Name
Previous Last Names (if any)
 
Gender
Birthdate
Social Security Number
 
Address Information
 
Mailing Address
 
 
City
State
Zip Code
 
Email Address
 
 
Primary Phone Number
Primary Phone Type
 
Secondary Phone Number
Secondary Phone Type
 

 
Have you ever had a felony conviction?
 
 
 
If yes, please explain:
 
Do you consent to a criminal history check?
 
 
Optional Information
 
Please list any religious affiliation you may have
 
 
Are you a US citizen?
If no, indicate your status:
 
 
Are you Hispanic or Latino?
 
 
What is your race?
American Indian/Alaska Native
 
 
Asian
 
 
Black or African American
 
 
Native Hawaiian/Other Pacific Islander
 
 
White
 

 
Enrollment Information
 
Application Information
 
Start Term
I will be a:
 
 
Do you plan to live in campus housing?
 
 
What is your anticipated major?
 
Please describe your future career goals:
 
 
How did you first learn about McKendree?
 
Have you visited campus?
If yes, please provide the date and circumstance.
 
 
 
 
 
 
 

 
Educational Background
 
High School Information
 
High School
City
State
 
Dates attended
 
 
Graduation Date (MM/YYYY)
 
High School GPA
Rank in Class
Class Size
 
 
Last Name at time of attendance:
   
 
 
High School
City
State
 
Dates attended
   
 
High School
City
State
 
Dates attended
   
 
Please list your senior year courses
 
 
 
 
Test Information
 
I have not yet taken a college entrance exam
 
 
Composite ACT Score
     
 
SAT Verbal
SAT Math
SAT Writing
 
 

 
Family Information
 
Parent Information
 
First Name
Last Name
 
Relationship to you
 
 
Mailing Address (if different)
City
State
 
Zip Code
 
 
Email Address
Home Phone
Cell Phone  
 
Occupation
Colleges/Universities Attended
 
First Name
Last Name
 
Relationship to you
 
 
Mailing Address (if different)
City
State
 
Zip Code
 
 
Email address
Home Phone
Cell Phone
 
Occupation
Colleges/Universities Attended
 
 
Sibling Information
 
 
 
McKendree Relatives
 
 
 
 
 
 

 
Personal Statement
 
 
 
 
 

 
Applicant's Affidavit
 
 
Initials
Date (MM/DD/YYYY)