YOUR PERSONAL INFORMATION YOUR PERSONAL INFORMATION First, middle and last name What you prefer to be called Street address City, State and Zip Code Email address Semester and year you plan to begin Fall Spring Year Student status Freshman Transfer student Do you have your own transportation? Yes No T-shirt size (for orientation purposes) Small Medium Large Extra-large YOUR CHILD(REN)"S INFORMATION YOUR CHILD(REN)'S INFORMATION Please include all of your dependent children First and last name Age/birthday Gender First and last name Age/birthday Gender Do you have a current custody order in effect for any or all of the children listed above? Yes No Because you have a custody order... Please email a copy of the order to kkough@wilson.edu Since you do not have a custody order in effect... Do you have a custody arrangement for any of the children listed above? If so, briefly explain this arrangement. BACKGROUND BACKGROUND Have you ever been convicted of a crime other than a traffic violation? Yes No Because you marked yes, please explain. Have any friends or members of your family, who would be visiting you, been convicted of a crime other than a traffic violation? Yes No Because you marked yes, please explain. Are there any past experiences in your life that may compromise your success as a student in the SPS Program? Yes No Because you marked yes, please explain. EMPLOYMENT EMPLOYMENT Employment status Unemployed Employed part-time Employed full-time Employer"s name Employer"s street address Employer"s city, county, state and zip Length of employment Years/months Hours worked per week ESSAY QUESTION ESSAY QUESTION In a paragraph, describe what your motivation is for joining the SPS Program and pursuing a degree at Wilson College. Agreement I agree I understand that if I am admitted into the Wilson College Single Parent Scholar Program I am to abide by the guidelines and conditions of the Single Parent Scholar Program lease and Wilson College Blue Book. I understand that any falsifications in this application may result in disqualification to or dismissal from the program. By checking this box, I agree that all of the information provided is accurate and is not exempt from a criminal background check First and last name Date Submit Leave this field blank
