Undergraduate Admission Application

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Fields in bold red font are required.  

Transfer applicants - Apply Here
This application form WILL NOT BE ACCEPTED for transfer students.

International applicants - Apply Here
This application is for US students only.

By completing this application, I authorize my high school to release my personal and academic information to La Roche College representatives.  I understand that official high school transcripts and the results of my SAT/ACT examination must be received by the Office of Admissions at La Roche College before an admissions decision can be made.

First Name: Middle: Last:

Any additional names used, please list and separate by commas.


Street Address:

City: State: Postal Code:

Telephone: (Home)      (Cell)   

Permanent Address (if different from mailing address):

Street Address:

City: State: Postal Code:

If student is under 18 years of age, please provide the following information:

Parent Name:

Parent Street Address:

Parent City: State: Postal Code:

Parent Telephone:

Parent E-mail Address:


Student E-mail Address:

Date of Birth: (mm/dd/yyyy)     Social Security Number:

Country of Citizenship:   Gender: Male    Female


How would you describe yourself?
Ethnicity: Hispanic of any origin (Spanish, Mexican, Puerto Rican, etc.) Yes   No

Please select from one or more of the following:
Black or African-American
American Indian/Alaskan native
Native Hawaiian or Pacific Islander


Enrollment Date:

Residency Status: Resident    Commuter

High School attended:     Graduation Month: Year:


SAT score:
        Will you be retaking the SAT? Yes    No

ACT score:
        Will you be retaking the ACT? Yes    No

Other schools you are applying to:




Have you taken AP or Honors classes? Yes    No

Have you taken college courses while enrolled in high school? Yes    No

If "Yes", which college?

Would you like to be considered for the Honors Institute? Yes    No

Division III Athletic Interests:
(Ctrl + Click to select multiple)

Non-athletic Interests:

Is your parent(s) a La Roche College alumni? Yes    No

If yes, exact name of the parent when he/she was a student at La Roche College:

Are you the son/daughter of a full-time La Roche College employee? Yes    No

Are you a veteran/active duty military or a dependent of one?
    Veteran/active duty military    Dependent Neither

Promotional Code:

ESSAY (optional)

In 250 words or less, please share why earning a college degree specifically from La Roche College is important to you, and why you believe a La Roche education will help you to achieve your life goals.

Word Count: