2015 Pre-College/Summer Bridge Program Enrollment

The deadline for submission of this form is Friday, May 1, 2015

Part 1 - Personal and Contact Information

, ,
Last
First
Middle
/ /
mm
dd
yyyy
Female Male
Street Address 1
Street Address 2
,
City
State
Zip Code
Country
() -
Home Telephone
() -
Mobile Telephone
() - [Extension ]
Work Telephone
() -
Home Telephone

Part 2 - Academic Information

High School GPA
SAT Math/Verbal
ACT Math/English
mm
yyyy

Note: Students with disabilities or learning differences are encouraged to disclose and forward all supporting documentation to the Director of Compliance and Disability Services in the Office of Testing Services. Please send all information to Hampton University, Wigwam Building, Room 212 Hampton, Virginia 23668. For additional information please call (757) 727-5493.

Yes No Yes No
Please separate with commas.
Yes No
Please separate with commas.
Please separate with commas.


Part 3 - For which program are you applying?


Pre-College
The Pre-College program is for students who are admitted and plan to enroll at Hampton University in the fall. In addition to English and math, Pre-College students are permitted to enroll in one of the courses below. Please indicate your first, second, and third choice. Please use numerals. Enrollment is based strictly upon availability.

African-American History
Introduction to Computers
Introduction to Political Science
Introduction to Sociology
Speech (Oral Communication)
World Civilizations II

Must submit: enrollment form, $500.00 non-refundable deposit, and a completed medical form.
Summer Only
The summer only program is for students who have not applied to Hampton University and plan to attend another college in the fall. This student may enroll in two courses: history, oral communications, or a social science only.
Must submit: enrollment form, $500.00 non-refundable deposit, summer session application, ACT or SAT test score(s), high school transcript, college/university acceptance letter and a completed medical form.
Rising Seniors
Students entering their senior year of high school in the fall may enroll in a maximum of two (2) courses; history, oral communications, or a social science.
Must submit: enrollment form, $500.00 non-refundable deposit, summer session application, ACT, SAT or PSAT test score(s), high school transcript, two letters of recommendation, and a complete medical form. These students must have a minimum 3.0 grade point average.
Summer Bridge (by invitation only)
This program is for students who are conditionally admitted to Hampton University pending successful completion of this program. These students are required to take two (2) courses, English and math, and earn a 2.5 GPA by the end of the program.
Must submit: enrollment form, $500.00 non-refundable deposit, and a complete medical form.