95 acres on Lake Michigan

Carthage Admissions: Information Request Form

NOTE: If you are an adult learner, you might be looking for information about Carthage's College at Night, ACE (Accelerated Carthage Education), Paralegal, or Graduate programs.

All fields in Red bold type must be completed!

PERSONAL INFORMATION
First Name:
Middle Name:
Last Name:
Preferred First Name:
Sex:	Male Female
Home Phone:
E-Mail Address:
Confirm E-Mail:

MAILING ADDRESS
Number and Street:
Additional Address Line:
City/Town:
State/Province:
Zip/Postal Code:
Country:

EDUCATIONAL PLANS
I would enter Carthage as a:
Freshman	Transfer
I would enter Carthage at the start of the following term:
Fall Term	January Term
Spring Term	Summer Term
I would enter Carthage in year:
Intended Area(s) of Major/Study:

Extracurricular Interests:

EDUCATIONAL BACKGROUND
High School:
City, State:
Country:
Year of HS Graduation:
College (if any):
City, State:
Current GPA:	on a scale
ACT Composite:
SAT Composite:

HIGH SCHOOL BACKGROUND
High School:
City, State:
Country:
Year of HS Graduation:
ACT Composite:
SAT Composite:

COLLEGE BACKGROUND
Current GPA:
Member of Phi Theta Kappa:	Yes No
College:
City, State:
Dates Attended:
	from	to

College:
City, State:
Dates Attended:
	from	to

College):
City, State:
Dates Attended:
	from	to

OPTIONAL INFORMATION
The following religious/ethnic responses are optional and are used only for statistics and/or grant consideration.
Predominant Ethnic Background
Predominant Religious Background

SPECIFIC QUESTIONS ABOUT CARTHAGE
If you have a specific question about Carthage that you would like answered, please ask it here: