Dual Admission Program Intent to Enroll Form

Dual Admittance students must complete this form prior to earning 30 credit hours.
All fields are required to be completed.

Personal Information

Email Address

Preferred Name

First Name

Last Name

Birthdate

Pronouns

Columbus State Cougar ID Number

Columbus State Major

Intended Academic Program at Capital University

Intended Start Term at Columbus State

Intended Start Term in Dual Admission Program

Intended Start Term at Capital University

Have you completed more than 30 college credit hours, including CCP?

How many credit hours have you completed (including CPP)?

Disciplinary History

Capital University is dedicated to creating a safe and welcoming environment for all students. Answering yes to the following questions will not automatically preclude you from admission, but may require additional review.

Have you been suspended or expelled from any high school or college/university? Disciplinary action includes any probation, suspension, removal, dismissal, or expulsion as a result of any academic or behavioral misconduct.

Yes

No

Have you been convicted or pleaded guilty to a felony within the last 7 years?

Yes

No

Have you been found responsible for any academic or other misconduct at any high school, college or seminary?

Yes

No

If you have selected yes for any of the above questions, please give the approximate date of each incident, explain the circumstances, and reflect on what you learned from the experience.

Additional Scholarship Opportunities

In addition to the Main Street Scholarship, additional scholarships may be available to you. Please answer the following questions for full scholarship consideration.

Religious Affiliation

Do you have a sibling currently enrolled as an undergraduate student at Capital University?

Yes

No

Sibling Name (Please provide first, last and maiden, if applicable.)

Sibling Graduation Year

Do you have any relatives who have graduated from Capital University, Trinity Lutheran Seminary, or Capital University Law School?

Yes

No

Relative Name (Please provide first, last and maiden, if applicable.)

Relative Relationship

Relative Graduation Year

Students participating in the Dual Admission Program are eligible for on campus housing at Capital University while enrolled at Capital University as well as during their time at Columbus State Community College, before even taking courses at Capital. Are you interested in receiving information about living on Capital's campus?

Yes

No

Intent to Enroll Acknowledgment

Electronic submission of this Intent Form is accepted as your signature indicating your intention to participate in the Columbus State Community College – Capital University Dual Admission Program. This Intent Form also serves as a Release of Information that authorizes the institutions to share appropriate admission, financial, academic, and advising information about your student record. By submitting this form, you are agreeing to abide by the policies and procedures of the Dual Admission Program, Columbus State Community College, and Capital University.

By signing below and submitting this form, I acknowledge my intent to enroll at Capital University.