Any additional names used, please list and separate by commas.
Permanent Address (if different from mailing address):
If student is under 18 years of age, please provide the following information:
Parent Street Address:
Parent E-mail Address:
Student E-mail Address:
Date of Birth: (mm/dd/yyyy)
Social Security Number:
Country of Citizenship:
How would you describe yourself?
Ethnicity: Hispanic of any origin (Spanish, Mexican, Puerto Rican, etc.)
Please select from one or more of the following:
Black or African-American
American Indian/Alaskan native
Native Hawaiian or Pacific Islander
High School attended:
Will you be retaking the SAT?
Will you be retaking the ACT?
Other schools you are applying to:
Biology (Bachelor of Arts)
Biology (Bachelor of Science)
Child and Family Studies
Communications, Media, and Technology
Dual Mid Level Social Studies Ed and History
Dual Mid Level Social Studies Ed and Politial Sci
English Studies: Journalism & Professional Writing
English Studies: Language and Literature
Film, Video & Media
Management Information Systems
Mathematics (Liberal Arts)
Middle Level Education - English/Lang Arts/Reading
Middle Level Education - Mathematics
Middle Level Education - Science
Middle Level Education - Social Studies
National Security Studies
PREK4 TEACHER EDUCATION/SPECIAL EDUCATION
Performing Arts-Dance Performance
Self-Designed Interdisciplinary Studies
--- CO-OP MAJORS WITH A PARTNER SCHOOL ---
Health Science Degree Completion Option
LECOM Dental Medicine 4+4 Program
LECOM Medicine 3+4 Program
LECOM Medicine 4+4 Program
LECOM Pharmacy 3+4 Program
LECOM Pharmacy 4+4 Program
RN TO MSN PROGRAM
Speech and Language Pathology
Have you taken AP or Honors classes?
Have you taken college courses while enrolled in high school?
If "Yes", which college?
Would you like to be considered for the Honors Institute?
Division III Athletic Interests:
(Ctrl + Click to select multiple)
Is your parent(s) a La Roche College alumni?
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?
Are you a veteran/active duty military or a dependent of one?
Veteran/active duty military
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.