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Kansas State University

Application Form

Student Services

Application Form

Please complete the following form. When you are finished, please select print at the bottom of the form.

I am (check all that apply): 21+ years old a parent re-entering

Name: Student ID:
Home address: Home phone:
  Work phone:
Major:
Employment within last year (please indicate average hours per week):
Honors, achievements, or scholarships (college, community, other):
Other colleges attended:
Hours completed toward degree (including transfer credits):
Classification for the Fall 2008 semester (check as many as apply):
    first year continuing student transfer returning
Anticipated status for the Spring 2008 semester:
    Freshman Sophomore Junior Senior Graduate
K-State date of entry (or re-entry):
K-State:
    Total undergraduate hours:       Undergraduate GPA:
    Total graduate hours:       Graduate GPA:
Transfer:
    Total undergraduate hours:       Undergraduate GPA:
    Total graduate hours:       Graduate GPA:

Signature:__________________________________________ Date:_____________


Return to: Maurine Allison O'Bannon Memorial Scholarship Committee, Division of Continuing Education, 226 College Court, Manhattan, KS 66506-6002. If you have any questions, please call 800-622-2578 or email informationdce@k-state.edu.