Non-Degree Application

Non-degree seeking students who are taking a Mansfield University course for the first time must complete this application/registration form.

A one-time, non-refundable/non-transferable application fee of $25 must accompany this form. You may pay your application fee online by accessing our secure site after submitting this application or mail your check (made payable to MU) to:

Admissions Office
Mansfield University
71 S. Academy St
Mansfield, PA 16933

 

Students admitted to the University in a degree program must follow registration procedures outlined in the Registration Schedule & Instructions.

 

*Required

*Student Last Name:   *First Name:    M.I.:

Social Security No.: (xxx-xx-xxxx)
The Federal Privacy Act of 1974 requires that you be notified that disclosure of your Social Security Number is voluntary and is not required to determine admission. Your Social Security Number will be used to match your application with your SAT/ACT Test Scores and/or Financial Aid information so failure to provide it may affect your eligibility for financial aid and may delay decision of admission. Your Social Security number is also used to report your educational expenses to the Internal Revenue Service to verify any education-related deductions you may claim on your federal income taxes.

*Gender: Male   Female      *Date of Birth:

Home Phone: (xxx-xxx-xxxx)      *Cell Phone Number: (xxx-xxx-xxxx)

 

*Permanent State Address:

*City:   *State:   *Zip Code:

County: Length of Permanent Residence:

Local Mailing Address (if different from Permanent address above):

Street: County:

City:  State:  Zip Code:

Daytime Phone:  Home Phone:

*Email Address:

 
 

Last Name(parent, guardian, spouse):    First Name(parent, guardian, spouse):

Legal Address of Parent, Guardian, or Spouse:

Street:

City:    State:    Zip Code:

Relationship (parent, guardian, spouse):

 
 

Name of High School:

Street Address of High School:

City:     State:     Zip Code:

Date of High School Graduation (month/year):

*If not a high school graduate, do you possess a GED? Yes    No

If yes, Date GED earned (mm/yy):

For Veterans: Date of Service     Branch of Service:

 

*Are you a United States Citizen?: Yes   No

If no, what is your Visa status?

 
 

*Semester & year you wish to enroll in at Mansfield University:

  

*Do you plan to commute or live on campus? Commute   Live on Campus

*Enrollment Category:

Non-Degree student taking undergraduate credit courses for enrichment.
Transitory. non-degree student planning to/already attending another college/university. will transfer MU credits to that college/university after attending here one semester or more
College Bound. High school juniors & seniors taking MU undergraduate coursework through the College Bound Program.
External Certification. Undergraduate non-degree student taking courses to fulfill external (non-MU) certification programs.
Post Baccalaureate Enrichment. Post baccalaureate student taking undergraduate coursework for enrichment.
Distance Ed (Technology). Non-degree student taking distance education coursework only.
Visiting Student. A student taking coursework at MU who is enrolled in a degree program at one of the SSHE sister schools.
An undergraduate or graduate student who has not been accepted to the University by either Admissions or Graduate Studies who is requesting to audit coursework only.
International non-degree students taking distance education coursework only.

*Have you attended any post-secondary institution, including MU? Yes   No

If Yes, list Name/ Location/Dates of Attendance/Major/Degree/Date Received(mm/yy) for each institution in the order of attendance:

*Are you currently attending the last institution mentioned? Yes   No

 
Ethnic/Racial Identification:

We ask each applicant to provide information about his/her ethnic & racial background. We use this information solely to help us in determining whether the university is being successful in its efforts to assure equal opportunities to all persons. Please select the appropriate ethnic & racial identification below:

What is your ethnicity?

What is your race? Mark one or more races to indicate what you consider yourself to be:




White

Course Registration

For course information, please access Registration Information:

 

Enter Session, Course Prefix, Course Number, Course Title, Course Meeting Times, Course Credits
(Example: IA-THT 1110 01 Intro to Theatre, Mo/We/Fr 9 am, 3 credits) :

 

*ACT 48: Is this course being taken to satisfy the Commonwealth of Pennsylvania Act 48 regulations?   Yes   No

If yes, you are responsible for selecting courses applicable to your area of certification or your job assignment.

 
 

Where did you hear about Mansfield University or this program?

Admissions Counselor
Billboard
College Search Website, i.e. College Board, Hobsons, etc.
Facebook
Friend
Magazine 
Mansfield University Web site
Newspaper
Relative
Radio
Teacher/Guidance Counselor
TV
Web search

Other (please list)

 

European Union General Data Protection Regulations Policy

CONSENT FOR THE COLLECTION AND PROCESSING OF SENSITIVE OR PERSONAL DATA
FROM THE EUROPEAN UNION FOR ADMISSION AND ENROLLMENT PURPOSES

  1. Pursuant to the European Union General Data Protection Regulation (EU GDPR), the Pennsylvania State System of Higher Education and its member universities, including Mansfield University of Pennsylvania, in its capacity as a data controller under the EU GDPR, must obtain explicit, affirmative consent before it can collect or process any sensitive or personal data for a lawful basis including for admission and enrollment purposes.
     
  2. Sensitive data includes data revealing racial or ethnic origin; political opinions; religious or philosophical beliefs; trade union membership; genetic or biometric data; health data; or data concerning a person's sex life or sexual orientation.
     
  3. Any sensitive or personal data that is collected will be for the sole purpose of application for admission to the University that is sent from the EU and is necessary for that purpose or for any purpose permitting the use of sensitive or personal data under applicable law or to meet other compliance obligations of the University.
     
  4. I understand that any sensitive or personal data that is collected will also be used to report serious illness, injury, or other health or emergency situations involving me, as well as to address or report discrimination, harassment, sexual or gender-based misconduct and criminal behavior which may be committed by or against me or otherwise involve me, on or off campus, to appropriate authorities including staff, faculty, and administrators of the University or appropriate legal or governmental authorities under applicable policies of the Pennsylvania State System of Higher Education or the University (including but not limited to applicable codes of conduct) and applicable laws (including but not limited to Title IX and the Clery Act).
     
  5. I understand that refusal to consent to the use of sensitive or personal data, and the transfer of sensitive or personal data overseas, for the purpose outlined in this notice may make it impossible for the University to carry out necessary activities, and may preclude the University's ability to provide requested services.
     
  6. I understand I have the right to withdraw consent to the collection and processing of sensitive or personal data and to do so, I must contact the GDPR compliance officer at jcosgrov@mansfield.edu.  I also understand that the complete deletion of data will not be feasible in all situations to ensure the University's ability to comply with regulatory requirements.

NOTE: Applications may not be reviewed until the application fee has been received. Completed applications are process in the order they are received on a first-come, first served basis. You are responsible for checking course prerequisites.

Send Questions / Comments to Contact Ruth Hermansen or call 1-570-662-4204