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Application
Please type in the requested information.
Applications received by June 1, 2011 will be given priority consideration. Applications received after this date
will be considered dependent upon space availability in each community.
 First Name
 Last Name
 University Banner ID Number
Permanent Address
 City
 State Zip
Local Address (if different than above)
 City
 State Zip
Home Phone
 Cell Phone
 University E-Mail Address
High School Accumulative GPA:
 Intended Major:
 Date of Birth (MM/DD/YYYY)
  Gender:  
How would you describe yourself? (Optional)
African-American/Black Caucasian/White Pacific Islander American Indian Hispanic or Latino
Asian American/Asian Multi-Racial Other
     
Academic Information: If you are not a first year freshman, please complete the following information:
Current Class Standing (Check One) Freshman Sophomore Junior Senior
Academic Credit Hrs.
at Time of Application: 		Cumulative GPA: Expected Graduation Date: (MM/DD/YYYY)

Please respond to the following questions:
1. I’m interested in the following Living Learning Community:
(If you are interested in multiple communities, please check all that apply)
Business Living Learning Community Fine Arts Appreciation Community
Flight Living Learning Community GPS Living Learning Community International Living Learning Community
STEM Living Learning Community Wellness Education, Living & Learning Community
     
2. What do you hope to gain as a result of your involvement in a Living Learning Community?
     
3. What can you bring to other members of your community?
     

4. How did you learn about Living Learning Communities? (Check all that apply)
YSU’s Website Flyer SOAR or EARLY Faculty/Staff Email
Other:

     
I understand that participation in a Living Learning Community is a privilege and that students enrolled in this program must reflect standards of conduct and academic performance consistent with the goals of the program. I certify that to the best of my knowledge, the information provided on this application is true and accurate. I authorize staff responsible for Living Learning Communities to verify all information related to program requirements including access to academic and student conduct records.
Full Name
 Date: (MM/DD/YYYY)