Dual Enrollment- Continuing As Freshman Application

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Middle Georgia State University

Name and Contact Information












Emergency Contact Information









BIOGRAPHICAL INFORMATION:







RESIDENCY INFORMATION:

1. University System of Georgia students are responsible for registering under the proper tuition classification. In general, classification of in-state status for tuition purposes requires an individual to have established domicile in Georgia for a minimum of 12 consecutive months, immediately preceding the first day of classes for the term in which the student plans to enroll.

2. Domicile is defined as a person’s present, permanent home where the individual intends to stay indefinitely and to which that individual returns following periods of temporary absence. Temporary residence does not constitute the establishment of one’s domicile.

3. Residency is defined as the state and country where an individual currently lives. An individual may reside in Georgia without having established domicile in Georgia.

4. Please note that this brief explanation of residency does not encompass all the rules on residency. If the applicant is in doubt about residency status, please contact the Graduate Admissions office.

5. The Board of Regents of University System of Georgia (USG) has recently instituted new policies that affect all applicants who seek in-state tuition at USG institutions. According to USG policy, individuals who apply, or are re-entering, for Fall 2011 and beyond must submit documentation of US citizenship or permanent residency before being considered for in-state tuition. MGA’s online tuition rate is a flat-rate, regardless of state of legal residence. 











EDUCATIONAL INFORMATION:

Failure to list all colleges previously attended may disqualify applicant. Transcripts must be received directly to the Office of Admissions from the originating institution. 














Program Information





BACKGROUND INFORMATION:






FAMILY HISTORY:





I understand that any material false statement made knowingly and willfully by me on this application, or any documents attached hereto may, in accordance with O.C.G.A. 16-10-71, which provides that upon conviction, a person who knowingly commits the offense of false swearing shall be punished by a fine of not more than $1,000 or by imprisonment for not less than one nor more than five years, or both, subject me to prosecution in a court of law. Additionally, I further understand than any such false statement may subject me to immediate dismissal from the institution.


All personal data and special categories of sensitive personal data collected or processed by the USG must comply with the USG Cybersecurity Plan, as authorized by the Board of Regents Policy Manual Section 10.4 Cybersecurity: www.usg.edu/policies. Anyone suspecting his or her sensitive personal data has been exposed to unauthorized access, report your suspicion to helpdesk@usg.edu. Otherwise, questions concerning general data privacy can be forwarded to dataprivacy@usg.edu. Signature (below) and submission of this application provides consent to and acknowledgement of the USG Privacy Policy.


Further, I certify that, to the best of my knowledge, the information submitted on this application is true and complete.



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