Michigan State University

Lifelong Education Application
US Citizens and Permanent Residents

 

ATTENTION: ALL ITEMS MARKED WITH Required-start time MUST BE COMPLETED

 
Required-citizen US Citizen:
Required-enterYear Year and Semester you wish to enter MSU:              
Required-name Name:

Required-sex         
Former Name:

A-

Student Number (if known)

Required-birthdate

MM/DD/YYYY

Required-address
Required-city
Required-state :
Required-zipcode :
Required-county :
Telephone Required-homephone
Required-email :

ETHNIC AND MULTIRACIAL GROUP

Note: Even if you are multiracial, please complete this item by indicating either the ethnic/racial group you identify with most or the ethnic/racial group to which you are usually regarded in the community as belonging. Check the appropriate number.

 

ARE YOU MULTIRACIAL?

If your answer is "Yes," please check the categories that correspond to the races of your parents.

 

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Required-previous education If you have or will receive a bachelor's degree or higher, or have attended other colleges or universities, enter the last school attended below and provide degree and graduation information. If you have not attended a college or university, enter the name of your high school.

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Required-security information Michigan State University seeks to admit students who provide evidence of intellectual performance, good character, and potential which will permit them to profit from programs of the academic rigor of those offered by Michigan State. The University recognizes that learning opportunities are enhanced by a secure environment. As part of the admissions process, we require applicants to respond to the following questions. Information provided in response to these questions needs to be reviewed, but rarely results in denial of admission.

  1. Have you ever been expelled, suspended, disciplined, or placed on probation by any secondary school or college you have attended because of (a)
    academic dishonesty, (b) financial impropriety, or (c) an offense that harmed or had the potential to harm to others?
                     
     
  2. Have you ever been convicted of a criminal offense (including in juvenile court) other than minor traffic violations or are there criminal charges pending
    against you at this time?
                     

If you answer “YES” to either #1 or #2, please submit a letter of explanation. If circumstances arise in the future (until the time you begin attending classes) that make your answers to the above questions inaccurate, misleading, or incomplete, you must provide the Office of the Registrar with updated information.

Please choose one of the following: I am taking these course(s) for:

 

To enroll, submit electronically,
mail or fax application to:

 
Emily Fink
Michigan State University
444 Erickson Hall
Lansing, MI 48824-1034
(517) 432-9259 Fax: (517) 353-6393
Email: edutech@msu.edu

 

I certify that I understand the restrictions as stated, that the items above have been completed correctly, and I agree to observe the rules and regulations of Michigan State University. If completing the form electronically type your full name on the signature line to sign.

 
Required-signature :
Required-date :
 
Course Number/Title
Site Name
Semester
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Michigan State University is an affirmative action, equal opportunity employer.