Office of the Registrar

MASTER DATA FORM

Intended Major

ID#                                   SSN 

Title

Name:  Last First Middle

Address                Phone

City   State    ZIP     Country  

Sex          Marital Status         Veteran 

Birthplace:  City/State        Birth date

Residence: State/Country   Cnty (IN residents)

Did either of your parents attend school after high school?   

Do you intend to complete a degree at Huntington College? 

Hometown Newspaper City/State

Denomination

Name of Home Church City/State

Race:     American Indian or Alaska Native     Asian    Black or African American
             Native Hawaiian or Other Pacific Islander     White

Ethnic Background:    Hispanic or Latino?

Name of your High School      Graduation Date

City/State

List any colleges you have previously attended

     Name of institution(s):                                                   Approximate dates attended:

 1. 

 2. 


If you are a dependent student, indicate the person who claims you as a dependent for tax purposes.

         Relationship

         Last First   Middle
         Mailing address if different from your own:
         Street
         City             State     ZIP

Are you a dependent student?   

Student's Signature _____________________________________ Date ___/___/___

If you are a dependent student, your signature gives the above named person right of access to your confidential educational records. In the event your dependent status changes, you must notify the Office of the Registrar to deny the individual the right of access. Non-confidential information, such as name, campus address, and activities, are routinely released by the College. You must inform the Registrar's Office, in writing, if you do not wish to have non-confidential information released to the public.
 


Please complete this form and return to:
Office of the Registrar
Huntington University
2303 College Avenue
Huntington, IN  46750
FAX: (260) 359-4086
Contact Us   |   2303 College Avenue  Huntington, IN 46750   |   260.356.6000   |   Copyright 2004